Therefore, a modified TIMI risk score devoid of the biomarker component was used in this study for comprehensive clinical risk assessment at patient admission to the emergency department. In this patient cohort, the clinical TIMI risk score outranged the clinical GRACE risk score in predicting CE at 30 days. These findings might at least in part be due to the different clinical criteria incorporated in the two risk scores and the different weighting of each criterion. While the GRACE risk score focuses more on clinical parameters on admission such as heart rate and systolic blood pressure, BMS-354825the TIMI risk score incorporates patient history including risk factors for coronary artery disease, known coronary artery disease, the use of antiplatelet therapy, and severe episodes of angina. Moreover, the endpoint definition of this study varies from the ones used to validate these risk scoring systems, and limited predictive value of the GRACE risk score has previously been described. However, this study was not designed to allow a comparison between different risk scoring systems,(+)-JQ1 and further studies are needed to compare predictive values of risk scores in different subsets of patients. In ST-elevation patients, distinctive ECG patterns usually determine an early invasive strategy with rare contraindications. However, the heterogenous population of Non-ST-elevation patients requires an appropriate patient selection for early revascularization. Although the combination of clinical parameters or risk scores, respectively with several conventional markers such as c-cTnT and NT-proBNP have occasionally been suggested, our findings show for the first time that integrating clinical and novel cardiac biomarker data including continuous hs-cTnT levels best predicted CE at 30 days in Non-ST-elevation patients. Stand-alone, cardiac biomarkers including hs-cTnT were not better predictors of CE compared to clinical judgment using the modified TIMI risk score. These findings further strengthen the value of traditional clinical practice in assessing the probability that the symptoms represent cardiac ischemia.