Explanation - TIMI Risk Score for STEMI: Comprehensive Overview
The TIMI Risk Score for STEMI (Thrombolysis In Myocardial Infarction) is a clinical tool used to estimate short-term (30-day) mortality in patients with ST-elevation myocardial infarction. It was developed by Morrow et al. (Circulation, 2000) using data from the InTIME-II trial, aiming to simplify bedside risk assessment at patient presentation.
Each clinical variable - such as age, hemodynamic status, Killip class, heart rate, and delay to treatment - contributes specific points, leading to a total score from 0 to 14. The higher the score, the greater the short-term mortality risk. This tool helps clinicians prioritize aggressive reperfusion, intensive monitoring, and prognostic counseling.
Clinical significance:
Patients with higher TIMI scores have significantly higher mortality and complication rates, reflecting the degree of myocardial compromise and systemic response. Although initially developed in the thrombolytic era, it remains valuable in modern PCI settings for risk stratification.
References:
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.
Antman EM, Cohen M, Bernink PJ, et al. The TIMI risk score for unstable angina/non ST elevation MI: A method for prognostication and therapeutic decision making. JAMA. 2000;284(7):835-842.