TIMI Risk Score for Secondary Prevention (TRS 2P) Calculator
Risk factor assessment
Select each clinical factor present. Each factor contributes one point.
The score summarizes the number of established clinical risk indicators. Interpret it in the context of the patient's clinical status and overall secondary-prevention assessment.
About the TRS 2P
The TIMI Risk Score for Secondary Prevention (TRS 2P; also written TRS 2°P) is a 0–9 point clinical risk score developed to stratify the risk of subsequent atherothrombotic events in patients with established atherosclerotic disease, particularly after myocardial infarction.
The score counts nine clinical risk indicators. Each present indicator contributes one point. The composite outcome used in the post-MI development/validation work was cardiovascular death, recurrent myocardial infarction, or ischemic stroke.
Risk indicators and points
| Risk indicator | Criterion | Points |
|---|---|---|
| Age | ≥75 years | 1 |
| Congestive heart failure | History of heart failure | 1 |
| Hypertension | History of hypertension | 1 |
| Diabetes mellitus | History of diabetes | 1 |
| Prior stroke | History of stroke | 1 |
| Prior CABG | History of coronary artery bypass grafting | 1 |
| Peripheral arterial disease | History of PAD | 1 |
| Renal dysfunction | Documented renal dysfunction | 1 |
| Current smoking | Current tobacco smoking | 1 |
Score interpretation
| Score | Risk stratum |
|---|---|
| 0 | Low risk |
| 1–2 | Intermediate risk |
| ≥3 | High risk |
These strata are presented as risk groupings, not as a patient-specific absolute event probability. Absolute event rates vary by cohort, follow-up duration, and endpoint definition.
Important use considerations
- This is a secondary-prevention risk stratification instrument, not an acute MI diagnostic or in-hospital mortality score.
- It does not estimate bleeding risk and should not be used alone to decide whether to extend dual antiplatelet therapy.
- External validation studies report modest discrimination and variation in calibration across populations.
References
Clinical notes
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