A family history of premature CAD is associated with increased coronary artery calcium scores119 and increased risk of 30-day cardiac events in patients with ACS.120,121 Diabetes mellitus, extracardiac (carotid, aortic, or peripheral) arterial disease, and hypertension are major risk factors for poor out- comes in patients with ACS (Section 6.2) with both STEMI122 The current or prior use of aspirin at presentation is associated with increased cardiovascular risk,42 likely reflecting the greater probability that patients who have been prescribed aspirin have an increased cardiovascular risk profile and/or prior vascular Table 3. TIMI Risk Score* for NSTE-ACS TIMI Risk Score All-Cause Mortality, New or Recurrent MI, or Severe Recurrent Ischemia Requiring Urgent Revascularization Through 14 d After Randomization, % *The 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 y of age; 3 risk factors for CAD; prior coronary stenosis 50%; ST deviation on ECG; 2 anginal events in prior 24 h; use of aspirin in prior 7 d; and elevated cardiac biomarkers. CAD indicates coronary artery disease; ECG, electrocardiogram; Ml, myocardial infarction; NSTE-ACS, non-ST-elevation acute coronary syndromes; and TIMI, Thrombolysis In Myocardial Infarction. Modified with permission from Antman et al.42 Amsterdam et al 2014 AHA/ACC NSTE-ACS Guideline e355 disease. Smoking is associated with a lower risk of death in primarily because of the younger age of smokers with ACS and less severe CAD. Overweight and/or obesity at ACS presentation are associated with lower short-term risk of death. 