# TIMI risk score for STEMI Status: LIVE Price: $0.005 USDC `GET /api/calc/timi_stemi` HTML: https://magentlab.com/docs/timi-stemi Markdown: https://magentlab.com/docs/timi-stemi.md Not a medical device. Not a diagnosis, dose, or listing recommendation. ## What it computes Compute the TIMI risk score for ST-elevation myocardial infarction from published bedside factors at presentation. ## When to use When an agent needs the Morrow 2000 TIMI STEMI arithmetic and must not invent points from a chart narrative. ## When not to use - Not a reperfusion or fibrinolytic protocol. The response is the integer score and components, not a mortality percent or treatment recommendation. - Age 65–74 and age ≥75 are mutually exclusive. Killip class, anterior ST elevation or LBBB, and time to treatment are caller-assigned; magent does not read an ECG or compute timestamps. - Diabetes, hypertension, or angina history contribute one point if any is true (not additive). ## Formula ``` TIMI STEMI = age 65-74 (2) or age >=75 (3) + diabetes/hypertension/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); max 14 ``` ## Citation TIMI risk score for ST-elevation myocardial infarction: A convenient, bedside, clinical score for risk assessment at presentation Morrow DA, Antman EM, Charlesworth A, Cairns R, Murphy SA, de Lemos JA, Giugliano RP, McCabe CH, Braunwald E Circulation. 2000;102(17):2031-2037 DOI: [10.1161/01.CIR.102.17.2031](https://doi.org/10.1161/01.CIR.102.17.2031) ## Worked example ### All-negative adult Given: `age=50, angina=false, anterior_ste_or_lbbb=false, diabetes=false, heart_rate_bpm=70, hypertension=false, killip_class=1, systolic_mm_hg=120, time_to_treatment_gt_4h=false, weight_kg=80` 1. Age 50 (<65) → 0; no diabetes/hypertension/angina; SBP 120 (≥100); HR 70 (≤100); Killip I; weight 80 kg (≥67); no anterior STE/LBBB; time to treatment not >4 h 2. Score = 0 ## Parameters - `age` (integer, required): Age in years (18-120). 65-74 scores 2; ≥75 scores 3. Bands are exclusive. - `diabetes` (boolean, required): Diabetes mellitus. true or false. Diabetes, hypertension, or angina scores 1 if any is true. - `hypertension` (boolean, required): Hypertension history. true or false. - `angina` (boolean, required): Angina history. true or false. - `systolic_mm_hg` (number, required): Systolic BP in mm Hg (50-250). Scores 3 when <100; 100 is negative. - `heart_rate_bpm` (integer, required): Heart rate in beats per minute (integer 30-220). Scores 2 when >100; 100 is negative. - `killip_class` (integer, required): Killip class 1-4. Classes II-IV score 2; class I scores 0. Caller-assigned. - `weight_kg` (number, optional): Weight in kilograms. Provide weight_kg or weight_lb. Scores 1 when <67 kg; 67 is negative. - `weight_lb` (number, optional): Weight in pounds. Converted to kg; the <67 kg cutoff is applied in kg. - `anterior_ste_or_lbbb` (boolean, required): Anterior ST elevation or LBBB. true or false. Caller-assigned; magent does not read tracings. - `time_to_treatment_gt_4h` (boolean, required): Time to treatment >4 hours. true or false. Caller-assigned; magent does not parse timestamps. ## Bulk (POST) POST the same path with a JSON items array. Price is n times the GET unit. Invalid items return HTTP 400 before settlement. Method: `POST /api/calc/timi_stemi` Max items: 25 Price: unit_amount * n (unit 5000 atomic) Status: PREVIEW - 1 to 25 items. Each item uses the same keys as the GET query parameters. - The first invalid item fails the whole request (index in the 400 JSON). You are not charged. - HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row. - Catalog misses (empty matches, found=false) stay paid 200s inside that slot. - x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items. Example request: ```json { "items": [ { "age": "50", "angina": "false", "anterior_ste_or_lbbb": "false", "diabetes": "false", "heart_rate_bpm": "70", "hypertension": "false", "killip_class": "1", "systolic_mm_hg": "120", "time_to_treatment_gt_4h": "false", "weight_kg": "80" }, { "age": "50", "angina": "false", "anterior_ste_or_lbbb": "false", "diabetes": "false", "heart_rate_bpm": "70", "hypertension": "false", "killip_class": "1", "systolic_mm_hg": "120", "time_to_treatment_gt_4h": "false", "weight_kg": "80" } ] } ``` Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/timi-stemi Example 200: ```json { "count": 2, "path": "/api/calc/timi_stemi", "items": [ { "components": [ { "value": 50, "factor": "age_65_74", "points": 0, "present": false }, { "value": 50, "factor": "age_ge_75", "points": 0, "present": false }, { "factor": "history_cad_risk", "points": 0, "present": false }, { "value": 120.0, "factor": "systolic_bp_lt_100", "points": 0, "present": false }, { "value": 70, "factor": "heart_rate_gt_100", "points": 0, "present": false }, { "value": 1, "factor": "killip_ii_iv", "points": 0, "present": false }, { "value": 80.0, "factor": "weight_lt_67", "points": 0, "present": false }, { "factor": "anterior_ste_or_lbbb", "points": 0, "present": false }, { "factor": "time_to_treatment_gt_4h", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Morrow DA, Antman EM, Charlesworth A, Cairns R, Murphy SA, de Lemos JA, Giugliano RP, McCabe CH, Braunwald E", "doi": "10.1161/01.CIR.102.17.2031", "id": "morrow-2000", "source": "Circulation. 2000;102(17):2031-2037", "title": "TIMI risk score for ST-elevation myocardial infarction: A convenient, bedside, clinical score for risk assessment at presentation" }, "formula": "timi_stemi", "formula_expression": "TIMI STEMI = age 65-74 (2) or age >=75 (3) + diabetes/hypertension/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); max 14", "weight_kg": 80.0, "age_years": 50, "max_score": 14, "score": 0, "systolic_mm_hg": 120.0, "heart_rate_bpm": 70, "angina": false, "anterior_ste_or_lbbb": false, "diabetes": false, "history_cad_risk": false, "hypertension": false, "killip_class": 1, "time_to_treatment_gt_4h": false }, { "components": [ { "value": 50, "factor": "age_65_74", "points": 0, "present": false }, { "value": 50, "factor": "age_ge_75", "points": 0, "present": false }, { "factor": "history_cad_risk", "points": 0, "present": false }, { "value": 120.0, "factor": "systolic_bp_lt_100", "points": 0, "present": false }, { "value": 70, "factor": "heart_rate_gt_100", "points": 0, "present": false }, { "value": 1, "factor": "killip_ii_iv", "points": 0, "present": false }, { "value": 80.0, "factor": "weight_lt_67", "points": 0, "present": false }, { "factor": "anterior_ste_or_lbbb", "points": 0, "present": false }, { "factor": "time_to_treatment_gt_4h", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Morrow DA, Antman EM, Charlesworth A, Cairns R, Murphy SA, de Lemos JA, Giugliano RP, McCabe CH, Braunwald E", "doi": "10.1161/01.CIR.102.17.2031", "id": "morrow-2000", "source": "Circulation. 2000;102(17):2031-2037", "title": "TIMI risk score for ST-elevation myocardial infarction: A convenient, bedside, clinical score for risk assessment at presentation" }, "formula": "timi_stemi", "formula_expression": "TIMI STEMI = age 65-74 (2) or age >=75 (3) + diabetes/hypertension/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); max 14", "weight_kg": 80.0, "age_years": 50, "max_score": 14, "score": 0, "systolic_mm_hg": 120.0, "heart_rate_bpm": 70, "angina": false, "anterior_ste_or_lbbb": false, "diabetes": false, "history_cad_risk": false, "hypertension": false, "killip_class": 1, "time_to_treatment_gt_4h": false } ] } ``` ## Response fields - `formula` (string): timi_stemi - `formula_expression` (string): Exact expression used - `score` (integer): Total points 0-14 - `max_score` (integer): Always 14 - `age_years` (integer): Age used for the 65-74 and ≥75 bands - `diabetes` (boolean): Diabetes flag used - `hypertension` (boolean): Hypertension flag used - `angina` (boolean): Angina flag used - `history_cad_risk` (boolean): true when diabetes, hypertension, or angina is true - `systolic_mm_hg` (number): Systolic BP used for the <100 cutoff - `heart_rate_bpm` (integer): Heart rate used for the >100 cutoff - `killip_class` (integer): Killip class 1-4 used - `weight_kg` (number): Normalized weight in kg - `anterior_ste_or_lbbb` (boolean): Anterior STE or LBBB flag used - `time_to_treatment_gt_4h` (boolean): Time to treatment >4 hours flag used - `components` (array): Per-factor points - `citation` (object): Circulation 2000 citation - `disclaimer` (string): Not-a-device notice ## Example JSON Frozen fixture. Not a live lookup. ```json { "components": [ { "value": 50, "factor": "age_65_74", "points": 0, "present": false }, { "value": 50, "factor": "age_ge_75", "points": 0, "present": false }, { "factor": "history_cad_risk", "points": 0, "present": false }, { "value": 120.0, "factor": "systolic_bp_lt_100", "points": 0, "present": false }, { "value": 70, "factor": "heart_rate_gt_100", "points": 0, "present": false }, { "value": 1, "factor": "killip_ii_iv", "points": 0, "present": false }, { "value": 80.0, "factor": "weight_lt_67", "points": 0, "present": false }, { "factor": "anterior_ste_or_lbbb", "points": 0, "present": false }, { "factor": "time_to_treatment_gt_4h", "points": 0, "present": false } ], "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.", "citation": { "authors": "Morrow DA, Antman EM, Charlesworth A, Cairns R, Murphy SA, de Lemos JA, Giugliano RP, McCabe CH, Braunwald E", "doi": "10.1161/01.CIR.102.17.2031", "id": "morrow-2000", "source": "Circulation. 2000;102(17):2031-2037", "title": "TIMI risk score for ST-elevation myocardial infarction: A convenient, bedside, clinical score for risk assessment at presentation" }, "formula": "timi_stemi", "formula_expression": "TIMI STEMI = age 65-74 (2) or age >=75 (3) + diabetes/hypertension/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); max 14", "weight_kg": 80.0, "age_years": 50, "max_score": 14, "score": 0, "systolic_mm_hg": 120.0, "heart_rate_bpm": 70, "angina": false, "anterior_ste_or_lbbb": false, "diabetes": false, "history_cad_risk": false, "hypertension": false, "killip_class": 1, "time_to_treatment_gt_4h": false } ``` ## Errors - HTTP 400 `invalid_age`: age must be an integer from 18 to 120 Returned before settlement; you are not charged. - HTTP 400 `invalid_flag`: boolean clinical flags must be true or false Returned before settlement; you are not charged. - HTTP 400 `invalid_systolic_bp`: systolic_mm_hg or systolic_bp_mm_hg must be a number from 50 to 250. Returned before settlement; you are not charged. - HTTP 400 `invalid_heart_rate`: heart_rate_bpm must be an integer from 30 to 220 Returned before settlement; you are not charged. - HTTP 400 `invalid_killip_class`: killip_class must be 1, 2, 3, or 4. Returned before settlement; you are not charged. - HTTP 400 `invalid_weight`: weight_kg (1-500) or weight_lb (2-1100) is required Returned before settlement; you are not charged. - HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged. - HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged. - HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged. - HTTP 402 `payment_required`: Missing or invalid PAYMENT-SIGNATURE; decode the PAYMENT-REQUIRED header - HTTP 409 `payment_in_progress`: The same authorization nonce is already being settled; retry shortly - HTTP 429 `rate_limited`: Too many requests from this client - HTTP 503 `settlement_uncertain`: Settlement is unconfirmed; retry with the same PAYMENT-SIGNATURE - HTTP 503 `settle_failed`: Settlement failed; retry with the same PAYMENT-SIGNATURE shortly - HTTP 503 `facilitator_unavailable`: Payment facilitator unavailable - HTTP 503 `facilitator_misconfigured`: Payment facilitator is not configured - HTTP 503 `facilitator_unauthorized`: Payment facilitator rejected credentials - HTTP 503 `ledger_unavailable`: Payment ledger unavailable - HTTP 503 `payment_unavailable`: Payment processing unavailable ## Related tools - [TIMI UA/NSTEMI](https://magentlab.com/docs/timi-ua-nstemi) — Compute the TIMI risk score for unstable angina / NSTEMI from age and six caller-assigned flags. ## Also searched as - TIMI STEMI - TIMI risk score STEMI - Morrow TIMI STEMI - TIMI ST-elevation MI - STEMI TIMI score ## Payment Required query parameters must be present and valid. Invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. - GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall). - HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote. - Sign EIP-3009 (scheme exact, assetTransferMethod eip3009) with validBefore = now + accepts[0].maxTimeoutSeconds (600 seconds). That window starts when you sign and must cover wallet confirmation plus CDP verify and settle. Magent retries transient facilitator 429/5xx before answering. Do not send upto or batch-settlement payloads; magent does not offer those schemes. - Retry the same URL with PAYMENT-SIGNATURE (base64 JSON echoing accepted, payload, and extensions when present). - Success is HTTP 200 JSON plus PAYMENT-RESPONSE. Settlement happens before the tool runs. HTTP 503 settlement_uncertain or settle_failed: retry the same PAYMENT-SIGNATURE. Mint a new nonce only after a new HTTP 402. - offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront. - not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search. - not offered `batch-settlement`: Not offered. Payment-channel vouchers claimed later in batches. Not the same as POST {items} bulk (that is still exact). Same-path POST {items} is still scheme exact: one EIP-3009 authorization for n times the GET unit. That is not x402 batch-settlement (payment channels / vouchers). ## Guarantees - Invalid query parameters return HTTP 400 before settlement. You are not charged. - Settlement finishes before the tool executes (paymentFlow upfront). Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE. - HTTP 402 is unpaid only. Do not sign a second authorization because of a 503. - Execution is timeout-bounded and concurrency-capped. - Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.