5
Table 2. Clinical Assessment and Initial Evaluation
Recommendation
COR LOE
Patients with suspected ACS should be risk stratified based on the
likelihood of ACS and adverse outcome(s) to decide on the need for
hospitalization and assist in the selection of treatment options.
I B
Table 1. TIMI Risk Score
a
for NSTE-ACS
TIMI Risk
Score
All-Cause Mortality, New or Recurrent MI, or Severe
Recurrent Ischemia Requiring Urgent Revascularization
Through 14 Days After Randomization, %
0-1 4.7
2 8.3
3 13.2
4 19.9
5 26.2
6-7 40.9
a
e TIMI risk score is determined by the sum of the presence of 7 variables at admission; 1 point is
given for each of the following variables: ≥65 years of age; ≥3 risk factors for CAD; prior coronary
stenosis ≥50%; ST deviation on ECG; ≥2 anginal events in prior 24 h; use of ASA in prior 7 d;
and elevated cardiac biomarkers.
Modified with permission from Antman EM et al. JAMA. 2000;284:835-842.
Table 3. ED or Outpatient Facility Presentation
Recommendations
COR LOE
Patients with suspected ACS and high-risk features such as
continuing chest pain, severe dyspnea, syncope/presyncope,
or palpitations should be referred immediately to the ED and
transported by emergency medical services when available.
I C
Patients with less severe symptoms may be considered for referral
to the ED, a chest pain unit, or a facility capable of performing
adequate evaluation depending on clinical circumstances.
IIb C
