ABSTRACT
I. BACKGROUND Patients undergoing major noncardiac surgery are at significant risk of cardiovascular morbidity and mortality (1,2). It is estimated that in Europe annually 40 million surgical procedures are performed, with a postoperative myocardial infarction (PMI) rate of 1% (400,000) and a cardiovascular mortality rate of 0.3% (133,000). Although the perioperative event rate has declined over the past 30 years in consequence of recent developments in anesthesiological and surgical techniques, for example, loco-regional anesthesia and endovascular treatment modalities, perioperative cardiac complications remain a significant problem (1,2).
