Patients presenting to the ED with acute chest pain undergo the SOC risk-stratification algorithm to determine the etiology of the complaint (Figure 1). The SOC risk-stratification initially includes the clinical assessment and an ECG. If the ECG reveals an ST elevation MI (STEMI) the patient is treated immediately in the cardiac catheterization laboratory. If the ECG is normal or indeterminate, and there are clinical risk factors, the patient will undergo cardiac biomarker testing. If the cardiac biomarkers are negative, the patient will then be admitted to the hospital for further testing. If the cardiac biomarkers are positive, the patient will be admitted to the cardiac care unit (CCU) for further testing. If the clinical risk factors are absent and the ECG is normal, the patient may be discharged without further testing4-8, however this is practiced in a small percentage (11%) of patients9. This practice risk-stratification algorithm continues to be the SOC. However, the combination of the Goldman predictor risk algorithm (ECG and symptoms) with a Troponin I (cTnI) < 0.3 was not able to identify a group of chest pain patients at <1% risk for the composite outcome of death, AMI or revascularization18. Further demonstrating the need for integration of additional testing that will decrease the false-positive and false-negative rates.