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TIMI Risk Score for STEMI

The TIMI STEMI score (0–14) estimates 30-day mortality after ST-elevation MI, from 0.8% at 0 points to 35.9% at >8 points, using age, comorbidities, SBP, heart rate, Killip class, weight, anterior STE/LBBB and time to treatment.

  • Age (years)
  • History of diabetes, hypertension or angina (yes/no, +1)
  • Systolic blood pressure (mmHg or kPa)
  • Heart rate (/min)
  • Killip class: I: no heart failure (0); II: rales/crackles, S3 or JVP raised (2); III: pulmonary edema (2); IV: cardiogenic shock (2)
  • Weight (kg or lb)
  • Anterior ST elevation or LBBB (yes/no, +1)
  • Time to treatment > 4 hours (yes/no, +1)
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Interpretation

ResultMeaning
00.8%
11.6%
22.2%
34.4%
47.3%
512.4%
616.1%
723.4%
826.8%
> 835.9%

Formula

Age 65–74: 2, ≥ 75: 3 · DM/HTN/angina 1 · SBP < 100: 3 · HR > 100: 2 · Killip II–IV: 2 · weight < 67 kg: 1 · anterior STE or LBBB: 1 · time to treatment > 4 h: 1

Clinical pearls

  • Derived in fibrinolysis-eligible patients (InTIME II); it still discriminates in primary PCI cohorts but absolute rates are lower today.
  • Score at presentation; it is not meant to guide reperfusion, which is indicated regardless of score.

Examples

timi stemi 78M anterior stemi, bp 95/60, hr 110, killip 2, 70 kgTIMI STEMI score for a 60 year old diabetic woman weighing 60 kg, SBP 130, HR 85, Killip I, presented 6 hours after onsetstemi risk 50M inferior, sbp 140 hr 70 killip 1 weight 85kg

FAQ

What does the TIMI STEMI score predict?

30-day all-cause mortality after STEMI, ranging from 0.8% at 0 points to 35.9% above 8 points.

What weight cut-off does TIMI STEMI use?

Weight under 67 kg (about 148 lb) adds 1 point.

Evidence

  1. Morrow DA et al. TIMI risk score for ST-elevation myocardial infarction. Circulation 2000;102:2031–7.

Cardiology · Reviewed 2026-10-14 · Methodology