TIMI Score

ARCA ACS



TIMI stands for 'Thrombolysis In Myocardial Infarction' and is the name of an Academic Research Organization (ARO) which was founded by Dr. Eugene Braunwald in 1984. It has conducted numerous practice-changing clinical trials in patients with cardiovascular disease or risk factors for cardiovascular disease.
The TIMI Study Group is affiliated with Brigham and Women's Hospital and Harvard Medical School, and is chaired by Dr. Marc Sabatine (founding Chairman Eugene Braunwald, MD (1982-2010)). Its headquarters are located in Boston, MA with a second location in Quincy, MA.

TIMI Risk Score is used in patients with Unstable Angina / Non-ST Elevation Myocardial Infarction. It is used to categorize a patient's risk of death and ischemic events and provides a basis for therapeutic decision making.

TIMI Score Calculation (1 point for each):
-Age >= 65
-Aspirin use in the last 7 days (patient experiences chest pain despite ASA use in past 7days)
-At least 2 angina episodes within the last 24hrs
-ST changes of at least 0.5mm on admission EKG
-Elevated serum cardiac biomarkers
-Known Coronary Artery Disease (CAD) (coronary stenosis >= 50%)
- At least 3 risk factors for CAD, such as: Hypertension -> 140/90 or on antihypertensives, Cigarette smoking, HDL < 40, Diabetes, Family history of premature CAD (CAD in male first-degree relative, or father less than 55, or female first-degree relative or mother less than 65).

Score Interpretation:
% risk at 14 days of: all-cause mortality, new or recurrent MI, or severe recurrent ischemia requiring urgent revascularization.
Score of 0-1 = 4.7% risk Score of 2 = 8.3% risk Score of 3 = 13.2% risk Score of 4 = 19.9% risk Score of 5 = 26.2% risk Score of 6-7 = at least 40.9% risk
Reference: "The TIMI Risk Score for Unstable Angina/Non–ST Elevation MI". JAMA. Website: [1]
Reference: "TIMI Study Group" [2]

'TIMI Grade Flow' is a widely adopted scoring system from 0-3 referring to levels of coronary blood flow assessed during percutaneous coronary angioplasty:
TIMI 0 flow (no perfusion) refers to the absence of any antegrade flow beyond a coronary occlusion.
TIMI 1 flow (penetration without perfusion) is faint antegrade coronary flow beyond the occlusion, with incomplete filling of the distal coronary bed.
TIMI 2 flow (partial reperfusion) is delayed or sluggish antegrade flow with complete filling of the distal territory.
TIMI 3 flow (complete perfusion) is normal flow which fills the distal coronary bed completely
'TIMI risk' estimates mortality following acute coronary syndromes. http://www.timi.org