"America": a mnemonic for the TIMI risk score

The TIMI risk score was developed in the USA to predict adversed outcomes
in patients with unstable angina and non-ST-elevation myocardial infarction. It is
used, both in the UK and the USA, as a risk stratification tool for patients with
undifferentiated chest pain, both to determine wich patients might be discharge early
and which should be targeted for early aggressive treatment.
The score itself is made up of seven predictor variables, and to help the
recollection of these (for examinations as much as for the shop floor), they can be
arranged into the following mnemonic:
A = Age ( greater than 65 years old ).
M =Markers ( raised serum cardiac markers ).
E = ECG (ST-segmen depression at presentation).
R = Risk factors at least three for coronary artery disease (Hypertension, family
history [coronary artery disease in father <55 yo and mother <65 yo],
hypercholesterolemia, diabetes, smoking, obesity, metabolic syndrome).
I = Ischaemia (at least two anginal events in previous 24 hours).
C = Coronary stenosis ( prior stenosis of 50% or more)
A = Aspirin (use in previous 7 days)
The simple prognostication shceme from the USA can easily be remembered
by this simple mnemonic, America.

Dr G Cattermole, Nevill Hall Hospital, Abergavenny.