TIMI Risk Score for ST-Elevation Myocardial Infarction (STEMI)

The TIMI risk score, based upon data from 15,000 patients with an ST segment elevation myocardial infarction eligible for fibrinolytic therapy, is a simple arithmetic sum of eight independent predictors of mortality.

TIMI Risk Score for STEMI
Historical
Age 65-74
>/= 75
2 points
3 points
DM/HTN or Angina 1 point
Exam
SBP < 100 3 points
HR > 100 2 points
Killip II-IV 2 points
Weight < 67 kg 1 point
Presentation
Anterior STE or LBBB 1 point
Time to rx > 4 hrs 1 point
Risk Score = Total (0-14)

DM, diabetes mellitus; HTN, hypertension; SBP, systolic blood pressure; HR, heart rate; STE, ST elevation; LBBB, left bundle branch block; and rx, treatment.

Risk Score Odds of death by 30D*
0 0.1 (0.1-0.2)
1 0.3 (0.2-0.3)
2 0.4 (0.3-0.5)
3 0.7 (0.6-0.9)
4 1.2 (1.0-1.5)
5 2.2 (1.9-2.6)
6 3.0 (2.5-3.6)
7 4.8 (3.8-6.1)
8 5.8 (4.2-7.8)
>8 8.8 (6.3-12)
* referenced to average mortality (95% confidence intervals)

 

 

References:

  1. Morrow DA, Antman EM, Charlesworth A, Cairns R, Murphy SA, de Lemos JA, Giugliano RP, McCabe CH, Braunwald E. TIMI risk score for ST-elevation myocardial infarction: A convenient, bedside, clinical score for risk assessment at presentation: An intravenous nPA for treatment of infarcting myocardium early II trial substudy. Circulation. 2000 Oct 24;102(17):2031-7. [Medline]
  2. Morrow DA, Antman EM, Parsons L, de Lemos JA, Cannon CP, Giugliano RP, McCabe CH, Barron HV, Braunwald E. Application of the TIMI risk score for ST-elevation MI in the National Registry of Myocardial Infarction 3. JAMA. 2001 Sep 19;286(11):1356-9. [Medline]

Created: Feb 18, 2007

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