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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