Does the LoD cutoff + the TIMI score = a NICE approach to rule-out a major adverse cardiac event in the emergency department?

The literature is abundant with accelerated diagnostic pathways (ADPs) for early decision making in emergency department (ED) patients presenting with chest pain (1-10). By in large, this growth in the various ADPs has been possible due to the introduction of high-sensitivity cardiac troponin (hs-cTn) testing. Published data, nearly a decade ago, demonstrated the utility of how the more analytically sensitive and precise hs-cTn assays can lead to an earlier diagnosis and provide important prognostic information for patients presenting with chest pain to the ED (11-13).