All patients with NSTE-ACS (NSTEMI or unstable angina) are treated similarly with respect to anti-ischemic and anti-thrombotic drugs. Management must, however, be individualized with respect to the delay to coronary angiography (PCI). The majority of patients should undergo angiography within 24 hours, but high-risk patients should be evaluated with angiography earlier. Guidelines recommend the use of validated risk models to estimate the risk of acute myocardial infarction, 30-day and 1-year mortality in patients with NSTE-ACS. TIMI, GRACE and PURSUIT are such risk models. The higher the estimated risk, the earlier should angiography be performed.
TIMI risk score for NSTEMI and unstable angina
[calc_timi_nstemi]
| TIMI SCORE | 30-days mortality | 30-days acute MI | Probability of revascularization |
|---|---|---|---|
| 0-1 | 1,2% | 2,3% | 1,2% |
| 2 | 1,0% | 2,1% | 6,0% |
| 3 | 1,7% | 3,7% | 9,5% |
| 4 | 2,5% | 5,0% | 12,2% |
| 5 | 5,6% | 8,5% | 14,3% |
| 6-7 | 6,5% | 15,8% | 20,9% |
