A method of determining the risk of an adverse cardiovascular event such as myocardial infarction, cardiac ischemia, heart failure, percutaneous coronary intervention, coronary artery bypass graft or death in a mammal consisting of the steps of: i) determining in a biological sample obtained from the mammal the concentration of a glucose metabolism biomarker selected from glucose or glycated hemoglobin Alc (HbAlc), and allotting a score of 1 when the concentration is greater than a normal level of the glucose metabolism marker; ii) determining in the biological sample the level of a heart function biomarker selected from red cell distribution width and a natriuretic peptide, and allotting a score of 1 when the level is greater than a normal level of the heart function biomarker, and/or determining in the biological sample the level of a renal function biomarker selected from creatinine or cystatin c and allotting a score of 1 when the estimated glomerular filtration rate (eGFR) which is based on the level of the renal function biomarker is less than the normal level of eGFR; iii) determining in the biological sample the level of at least one biomarker of cardiac injury selected from cardiac troponin T, cardiac troponin I and heart-specific fatty acid binding protein using a high sensitivity assay or a sensitivity assay, and allotting a score of 1 if the level is greater than the level of an ambulatory population at risk for future cardiovascular events but less than the level at which analytical variation occurs, allotting a score of 2 if the level is greater than the level at which analytical variation occurs and less than the upper limit of normal of a general population, and allotting a score of 3 if the level is greater than the upper limit of normal of the general population; and iv) generating a total laboratory score based on the sum of the scores for each of the biomarkers of i), ii) and iii), wherein a laboratory score of less than 1 indicates low risk of an adverse cardiac event in the mammal with a negative likelihood ratio of less than 1, and a laboratory score of greater than 4 when the level of a heart function biomarker or a renal function biomarker is determined, or greater than 5 when the level of a heart function biomarker and a renal function biomarker is determined, indicates a risk of an adverse cardiac event in the mammal with a positive likelihood ratio of greater than 1. i) determining in a biological sample obtained from the mammal the concentration of a glucose metabolism biomarker selected from glucose or glycated hemoglobin Alc (HbAlc), and allotting a score of 1 when the concentration is greater than a normal level of the glucose metabolism marker; ii) determining in the biological sample the level of a heart function biomarker selected from red cell distribution width and a natriuretic peptide, and allotting a score of 1 when the level is greater than a normal level of the heart function biomarker, and/or determining in the biological sample the level of a renal function biomarker selected from creatinine or cystatin c and allotting a score of 1 when the estimated glomerular filtration rate (eGFR) which is based on the level of the renal function biomarker is less than the normal level of eGFR; iii) determining in the biological sample the level of at least one biomarker of cardiac injury selected from cardiac troponin T, cardiac troponin I and heart-specific fatty acid binding protein using a high sensitivity assay or a sensitivity assay, and allotting a score of 1 if the level is greater than the level of an ambulatory population at risk for future cardiovascular events but less than the level at which analytical variation occurs, allotting a score of 2 if the level is greater than the level at which analytical variation occurs and less than the upper limit of normal of a general population, and allotting a score of 3 if the level is greater than the upper limit of normal of the general population; and iv) generating a total laboratory score based on the sum of the scores for each of the biomarkers of i), ii) and iii), wherein a laboratory score of less than 1 indicates low risk of an adverse cardiac event in the mammal with a negative likelihood ratio of less than 1, and a laboratory score of greater than 4 when the level of a heart function biomarker or a renal function biomarker is determined, or greater than 5 when the level of a heart function biomarker and a renal function biomarker is determined, indicates a risk of an adverse cardiac event in the mammal with a positive likelihood ratio of greater than 1.