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TIMI Score for STEMI Calculator

Created by Aleksandra Zając, MD
Reviewed by Dominik Czernia, PhD and Jack Bowater
Based on research by
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; Oct 200See 3 more sources
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; Sep 2001Khot UN, Jia G, Moliterno DJ, et al Prognostic Importance of Physical Examination for Heart Failure in Non–ST-Elevation Acute Coronary Syndromes The Enduring Value of Killip Classification; JAMA; Oct 2003Bruno Henrique Gallindo de Mello, Gustavo Bernardes F. Oliveira, et al. Validation of the Killip-Kimball Classification and Late Mortality after Acute Myocardial Infarction; Arquivos Brasileiros de Cardiologia; Aug 2014
Last updated: Jun 05, 2023


The TIMI score for STEMI calculator (Thrombolysis In Myocardial Infarction for ST-segment Elevation Myocardial Infarction) is an easy-to-use bedside tool to distinguish patients who are at most risk of a fatal outcome in the thirty-day follow-up. TIMI for STEMI risk score is a twin version of the TIMI Score calculator, which we use in unstable angina and non-ST-segment elevation myocardial infarct. It uses basic parameters and clinical assessment, among which just one – Killip class – serves as a single, strong predictor of mortality, which raises the scale's reliability even more.

We try our best to make our Omni Calculators as precise and reliable as possible. However, this tool can never replace a professional doctor's assessment. If any health condition bothers you, consult a physician.

When and why to use TIMI score for STEMI calculator?

Chest pain is one of the most common complaints on admission to the hospital. It can have dozens of causes, but if the patient seeks professional emergency help, it often turns out to be myocardial infarction. The diagnosis is severe and requires immediate, advanced medical help. Unfortunately, even the right treatment (like PCI – percutaneous coronary intervention) doesn't make all the risks go away. An injured heart needs time to recover. That's why the time right after admission and even after treatment is crucial - a patient is monitored continuously for a couple of days.

Among the group of already-at-high-risk-of-death patients, discriminating the most endangered persons and putting them under close observation in steadily monitored rooms or intensive care units can save their lives.

That's why the TIMI for STEMI Score was created. Developed in 2000 by Morrow et al. for patients with diagnosed STEMI (not just chest pains), it has been validated numerous times since then, and the results were always favorable. It is also simple to use – an evaluation shouldn't take more than a couple of minutes, especially if you have access to the patient's monitored data. Being such an easily applicable bedside tool that can save a patient's life, the TIMI STEMI risk score has become standard practice.

Using TIMI Score for STEMI

Using our calculator is as simple as it seems and can make your work easier. Just pick the age range from the drop-down list box and then select "Yes" next to the criteria that refer to your patient. You'll see more detailed information if you hover the mouse cursor over a single predictor. If you need more help, move to the section on the criteria below.

You'll see the result as soon as you fill in the final field. The result applies to mortality in general, not to, e.g., a direct complication of the myocardial infarction. However, if you want to estimate the risk for a patient not in an emergency right now, use other scales, like CVD risk calculator.

Thanks to our TIMI score for STEMI calculator, you don't have to remember the number values of each criterion anymore!

TIMI for STEMI risk score criteria

The TIMI STEMI risk score consists of eight different criteria. Some predictors (criteria) are simple critical parameters; some are more complex and require further patient evaluation. They all have different weights according to the adjusted odds ratios from logistic regression analysis - as in the original paper.

In the TIMI score, we'll find:

  • Age (2 or 3 points) – and we set apart two thresholds here, 65 and 75 years old.

  • Diabetes, angina pectoris, or hypertension (1 point) are all risk factors for coronary artery disease (CAD) and overall mortality. They usually contribute to the heart risk scales, such as in Framingham risk calculator.

  • Heart rate over 100 beats per minute (2 points) – healthy heart rate (resting) ranges from 60 to 100 beats per minute. If it's higher, it usually indicates that heart function is deteriorating.

  • Killip class II-IV (2 points) – requires a thorough physical examination of the patient; we use it to evaluate the heart failure grade – find out more in the paragraph dedicated to Killip class.

  • Systolic blood pressure <100mmHg (3 points) – hypertension is a predictor of mortality as well. Still, low arterial blood pressure might mean insufficient oxygen reaching the body's tissues.

  • Anterior lead ST elevation or left bundle branch block (1 point) – this TIMI STEMI score serves patients with ST-elevation myocardial infarction. The new left bundle branch block (LBBB) was considered to be an ECG infarction phenomenon for a long time, but now its role has been diminished, and it is recommended to use the Sgarbossa Criteria while assessing the ECG record.

  • Time to treatment >4 hours (1 point).

  • Body weight less than 150lbs (appr. <67kg) (1 point) – it was proven that low body weight correlates with increased mortality.

Killip class - close-up

Killip classification (sometimes called Killip-Kimball class) is a four-degree system used to evaluate the severity of heart failure in patients with acute myocardial infarction and enables us to assess the risk of death in the following month.

The scale is relatively old (first introduced in 1967) but was validated even in the 21st century, and the results state that the class is still a powerful predictor. It also shows the importance of the physical examination, which we sometimes forget about among all the modern equipment and digital parameters.

The table below shows the Killip classes. In the TIMI score for STEMI calculator, classes II-IV worsen the prognosis.

Clinical signs

Killip class

30-day mortality

No signs

I

2-3%

Rales or crackles in the lungs, S3 (third heart sound), elevated jugular veins pressure

II

5-12%

Acute pulmonary edema

III

10-20%

Cardiogenic shock, hypotension (SBP <90mmHg), oliguria, sweating, cyanosis

IV

10-20%

Aleksandra Zając, MD
Age
<65 years old
Presence of diabetes, hypertension or angina pectoris?
No
Heart rate >100 bpm
No
Killip class II-IV
No
SBP (systolic blood pressure) <100mmHg
No
Anterior lead ST elevation or LBBB
No
Time to treatment > 4 hours
No
Body weight less than 150lbs (67kg)
No
Result
0
Estimated 30-day all-cause mortality in this patient is 0.8%.
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