Laureano-Phillips J, et al. - In this systematic review and meta-analysis, researchers evaluated the diagnostic accuracy of a low-risk History, ECG, Age, Risk Factors, and Troponin (HEART) score for prediction of major adverse cardiac events in patients admitted to the emergency department (ED). Four subgroup analyses were undertaken: by geographic region, the use of a modified low-risk HEART score (traditional HEART score [0 to 3] in addition to negative troponin results), using conventional vs high-sensitivity troponin assays in the HEART score, and a comparison of different post–ED-discharge patient follow-up intervals. The final meta-analysis included 25 studies published from 2010 to 2017, with a total of 25,266 patients. Of these 9,919 (39.3%) patients were deemed to have low-risk HEART scores. Outcomes suggested that, despite its use in different patient populations, the troponin type used, and timeline of follow-up, a low-risk HEART score possessed high sensitivity, negative predictive value, and negative likelihood ratio for predicting short-term major adverse cardiac events. Risk of bias and statistical heterogeneity were high.