The bedside risk score TIMI Risk Score for STEMI (Morrow et al., Circulation, 2000): 8 clinical variables available at patient presentation, a 0–14 point total mapped to an estimated 30-day mortality from the InTIME-II study cohort. Check each applicable criterion — the score updates automatically.
The figure above is the 30-day mortality proportion in the InTIME-II study cohort (fibrinolytic era) for the same score — not a certain prediction for an individual patient. The risk categories (low/intermediate/high/very high) are groupings commonly used by clinicians, not part of the original Morrow 2000 publication. This score does not replace comprehensive clinical assessment.
| TIMI score | 30-day mortality | Risk category* |
|---|---|---|
| 0 | 0.8% | Low |
| 1 | 1.6% | Low |
| 2 | 2.2% | Low |
| 3 | 4.4% | Intermediate |
| 4 | 7.3% | Intermediate |
| 5 | 12.4% | High |
| 6 | 16.1% | High |
| 7 | 23.4% | Very high |
| 8 | 26.8% | Very high |
| >8 (9–14) | 35.9% | Very high |
*Risk categories are groupings commonly used in clinical practice (low 0–2, intermediate 3–4, high 5–6, very high ≥7) — not part of the original Morrow 2000 publication. Your patient’s score row is highlighted automatically.
The TIMI Risk Score for STEMI was developed by Morrow et al. and published in Circulation in 2000 as a substudy of the InTIME-II clinical trial (intravenous nPA for treatment of infarcting myocardium early II). It was designed as a bedside tool: it uses only 8 variables available when the STEMI patient presents, without waiting for laboratory results, so risk stratification can be done within minutes.
Scope: this page covers only the TIMI Risk Score for STEMI (Morrow 2000). The TIMI instrument for unstable angina / NSTEMI (Antman 2000) is a different score with different variables — do not mix the two. For comparison with the GRACE score (the full acute coronary syndrome spectrum) and the HEART score (chest pain in the ED), see the FAQ below.
Reference: Morrow DA, Antman EM, Charlesworth A, et al. TIMI risk score for ST-elevation myocardial infarction: a convenient, bedside, clinical score for risk assessment at presentation. Circulation. 2000;102(17):2031–2037. DOI: 10.1161/01.cir.102.17.2031. The variable weights and mortality table on this page were verified against the Merck/MSD Manual professional table and the official TIMI Study Group calculator.
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A bedside clinical risk score developed by Morrow et al. (Circulation, 2000) to estimate 30-day mortality in patients with STEMI (ST-segment elevation myocardial infarction). The score uses 8 variables available at patient presentation, totaling 0–14 points; each score maps to a 30-day mortality figure from the InTIME-II study cohort, for example score 0 → 0.8% and score >8 → 35.9%.
Add up points from 8 criteria: age 65–74 years (2 points) or ≥75 years (3 points, only one applies); history of diabetes, hypertension, or angina (1 point); systolic blood pressure <100 mmHg (3 points); heart rate >100 bpm (2 points); Killip class II–IV (2 points); weight <67 kg (1 point); anterior ST elevation or LBBB on ECG (1 point); and time from symptom onset to treatment >4 hours (1 point). The calculator above adds them automatically while showing the breakdown of each component.
Mapping from the Morrow 2000 publication (InTIME-II cohort): score 0 → 0.8%; 1 → 1.6%; 2 → 2.2%; 3 → 4.4%; 4 → 7.3%; 5 → 12.4%; 6 → 16.1%; 7 → 23.4%; 8 → 26.8%; and score >8 → 35.9%. These figures are the 30-day mortality proportions among patient groups with the same score in that study — not certain predictions for individual patients.
They are different instruments and must not be mixed. TIMI STEMI (Morrow 2000, this page) uses the 8 variables above with a maximum total of 14 points. TIMI for unstable angina/NSTEMI (Antman 2000) uses 7 different variables: age ≥65 years, ≥3 coronary heart disease risk factors, known coronary stenosis ≥50%, ST-segment deviation, ≥2 angina episodes in 24 hours, aspirin use in the last 7 days, and positive cardiac biomarkers — with a maximum total of 7 points and a different outcome.
The GRACE score assesses risk across the entire acute coronary syndrome spectrum using continuous variables such as age, creatinine, and cardiac biomarkers to predict in-hospital and 6-month mortality. The HEART score is used in the emergency department for chest-pain patients without a clear diagnosis, predicting major cardiac events within 6 weeks. TIMI STEMI is narrower and simpler: for confirmed STEMI patients only, calculated from 8 bedside variables without waiting for laboratory results.
This calculator is designed for healthcare professionals managing STEMI patients, as an aid for early risk stratification alongside comprehensive clinical assessment. Patients and families may use it for educational purposes, but interpretation of results and every clinical decision should be discussed with the patient’s treating physician.
Do not use this score for unstable angina or NSTEMI patients — use the instrument appropriate for that condition. This score must also not be the sole basis for treatment decisions; it does not replace clinical assessment, serial ECG interpretation, echocardiography, and monitoring of the patient’s clinical course during care.
Caution is warranted. This score was derived from a fibrinolytic-era cohort (the InTIME-II study, published in 2000), before primary PCI became the main reperfusion therapy for STEMI. In modern populations undergoing timely primary PCI, this score may overestimate actual mortality. Use it as one input alongside current clinical data, not as an absolute number.
The Killip classification describes the degree of heart failure in acute myocardial infarction: class I means no signs of heart failure; class II means pulmonary rales, a third heart sound (S3), or elevated jugular venous pressure; class III means pulmonary edema; and class IV means cardiogenic shock. In the TIMI STEMI score, Killip class II–IV is worth 2 points.
In the InTIME-II derivation cohort, low body weight was associated with higher 30-day mortality — possibly reflecting smaller physiologic reserve as well as other confounders in the study population. This variable is a population-level risk marker in that model, not advice to change body weight.
No. The mortality figures in the table are event proportions among patient groups with the same score in the InTIME-II study. Individual patients may fully recover or deteriorate regardless of that number. This score helps place a patient in a population risk stratum — it is a stratification tool, not a forecast for an individual.
The original publication: Morrow DA, Antman EM, Charlesworth A, et al. “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;102(17):2031–2037. DOI: 10.1161/01.cir.102.17.2031. The mortality table on this page can also be verified via the Merck/MSD Manual professional table and the official TIMI Study Group calculator.
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