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The Authors' reply The Randomised Assessment of Treatment using Panel Assay of Cardiac Markers (RATPAC) trial was a pragmatic evaluation comparing a specific point-of-care panel assessment to what is still standard diagnostic assessment for suspected myocardial infarction, a 12-hour laboratory troponin. The studies by Keller et al1 and Reichlin et al2 show that modern high sensitivity troponin assays have better sensitivity than older assays but troponin measurement at presentation is still suboptimal compared with delayed measurement. We are currently undertaking an economic analysis to determine whether delayed troponin measurement is cost effective compared with measurement at presentation.3 Until this analysis is undertaken, delayed troponin …