TIMI Score: What It Means and What to Do With a High Score

Medically Reviewed By Uzochukwu Ibe, MD, MPH
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The “TIMI” score stands for the “thrombolysis in myocardial infarction” score. It is one way doctors predict the risk of a serious heart problem. Doctors can use a TIMI score to help plan the next steps of treatment and identify when someone is at a high risk of a serious heart problem. Clinicians generally use a TIMI score alongside signs and symptoms of chest pain or a certain type of heart attack. If you are experiencing such symptoms, a medical team will consider your condition and use the TIMI score to predict what might happen next. This can help them prepare for how to treat your condition.

This article will explain how a TIMI score is calculated, what a high TIMI score means, and tips for preventing the risk of a cardiac event. 

Calculating TIMI score

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Clinicians calculate a TIMI score based on seven factors. Your condition gains 1 point for each factor you meet.

The higher the score or number of points, the higher your risk of experiencing a dangerous cardiac event. This includes acute coronary syndrome (ACS), a wide range of problems that can impact blood flow to the heart.

The factors of a TIMI score are:

  • being 65 years old or older
  • having at least three risk factors for coronary artery disease (CAD), which include:
    • you or someone in your family having cardiovascular disease, such as CAD
    • high cholesterol level
    • high blood pressure level
    • diabetes
    • smoking
  • experiencing coronary stenosis, a narrowing of the blood vessels in the heart by 50% or more
  • having two episodes of chest pain in the last 24 hours
  • using aspirin in the past 7 days
  • having blood test results that indicate necrosis
  • having ST-segment deviations of 0.5 millimeters or more

An ST-segment deviation indicates unusual electrical signals and coordination of the heart. Clinicians can measure this using an ECG test.

Learn more about the symptoms of chest pain and when it is serious.

Seek immediate medical care for the following symptoms of chest pain

If you experience risk factors of cardiovascular disease, seek emergency medical care for symptoms of chest pain.

Additionally, seek emergency care for anyone experiencing symptoms including:

Someone with a TIMI score of 3 or more may require immediate or intensive treatment. Seek immediate medical care if you believe you have a score of 3 or more.

Some factors are only measurable by doctors or specialized medical equipment. However, you may be able to recognize a score of 3 or more by knowing your own medical and family history, depending on the factors that affect your risk. For example, if you are 65 years or older, have diabetes, and have experienced two recent episodes of chest pain, your TIMI score is at least 3.

Accuracy

Clinicians and researchers consider the TIMI score to be an accurate form of predicting cardiovascular conditions. The TIMI score may be more effective in predicting ACS than other markers, such as physical examinations, cardiac markers, and health history.

The exact amount of risk may vary depending on what factors you experience. For example, researchers have observed that CAD, being over age 65, and ST-segment deviations may link to cardiac events more strongly than other factors. 

It may offer advantages over other diagnostic tools by accurately identifying people at high risk or who may need cardiac catheterization.

Other score methods, such as the CADILLAC and PAMI scores, may also be beneficial. For example, the CADILLAC score can help to predict outcomes over the following 6 months to 1 year.

Interpretation of results

Each factor you experience from the TIMI score is 1 point, and you can get up to 7 points.

The more points you get, the higher your TIMI score and your risk of a cardiac event occurring. Your risk of developing ACS also increases with each factor.

The TIMI score may also measure your combined risk of experiencing one of the following:

  • myocardial infarction, known as heart attack
  • cardiovascular blockage requiring medical care
  • death

Doctors measure the likelihood of these events occurring in risk percentages per TIMI score. The following table shows these percentages according to each score:

TIMI scorepercentage (%) risk
0–14.7%
28.3%
313.2%
419.9%
526.2%
6–740.9%

What to do if you have a high TIMI score

If you have a high TIMI score, discussing a treatment plan with your doctor is important.

People are most likely to have a heart attack or pass from cardiovascular conditions in the first week after symptoms appear. As such, prompt medical care can be crucial and even lifesaving.

Your doctor will recommend a treatment plan based on your score and symptoms. It is important to follow their treatment plan and continue monitoring your condition. Nearly one-quarter of cardiac events may happen 6 weeks after discharge from medical care.

Treatment options

If necessary, your doctor or medical care team will recommend treatment options to reduce your risk of a cardiac event. This treatment may vary slightly depending on your risk factors and your score level.

For example, doctors recommend treatments such as angiography and revascularization for people with a score of 3 or more. People with a score of 0–2 may be able to manage their condition with medication.

Treatment options include:

  • certain medications, such as:
    • blood thinners, or anticoagulants, such as aspirin
    • beta-blockers
    • calcium channel blockers
    • nitrates
  • cardiac catheterization and cardiac angiography, an invasive procedure to insert a tube into a blood vessel
  • revascularization to place a stent and open up a blocked or narrowed artery
  • lifestyle changes

Always let your doctor know if you have any heart conditions or a family history of heart disease.

How to prevent a high TIMI score

Some factors of heart disease are not preventable, such as your genetic risk.

However, you can modify other factors contributing to heart health, such as your diet and lifestyle.

According to the Centers for Disease Control and Prevention (CDC), you can lower your risk of heart disease by: 

  • quitting smoking or not smoking
  • maintaining a moderate weight
  • avoiding drinking alcohol, especially in excess
  • eating a balanced diet
  • exercising at least 30 minutes every day
  • managing any health conditions you may have, such as diabetes or high blood pressure
  • managing your stress

2018 study suggests that certain dietary patterns may help prevent cardiovascular disease. These dietary patterns include:

  • consuming more of the following:
    • fruits and vegetables
    • whole grains
    • nuts and legumes
    • seafood
    • drinks such as water, unsweetened tea, and coffee
  • limiting intake of foods such as processed meat, refined grains, and alcohol
  • limiting intake of foods containing:
    • added sugar, including sugar-sweetened beverages
    • trans and saturated fats
    • high levels of sodium

It is important to take any medications as your doctor prescribes and follow their recommendations for diet or other lifestyle factors.

Outlook

The higher your TIMI score, the higher your risk of experiencing a cardiac event. Sometimes, these events can be fatal.

However, the TIMI score can quickly and accurately predict these events. This allows for prompt, effective treatment and monitoring to help prevent events and reduce your risk in the future. With correct use, the TIMI score can be a lifesaving and cost-effective tool for cardiac health.

It is important to note that the TIMI score estimates overall risk and helps clinicians decide what approach to take. As a result, it is not a guarantee of illness or good health. Additional factors may still play a role in your condition.

Contact your doctor for personal guidance on what you can expect from your condition and treatment plan.

Summary

A TIMI score is a tool to help predict a person’s risk of a dangerous heart problem.

Clinicians calculate your TIMI score based on seven factors, each worth 1 point. Being 65 or older, experiencing certain ST-segment deviations, and having a history of CAD may especially increase your risk.

Most people with a high TIMI score will develop a heart problem within 1 week. As such, it is important to seek medical care to reduce your risk. You may need a procedure or medication to help protect your heart.

You can help lower your overall risk of heart disease by eating a healthy diet, exercising regularly, and managing stress levels and any underlying medical conditions.

Seek emergency medical care for severe chest pain.

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Medical Reviewer: Uzochukwu Ibe, MD, MPH
Last Review Date: 2022 Aug 30
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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