The pathophysiology of perioperative myocardial infarction has been explained by responses to perioperative surgical stress represented by a catecholamine surge with associated haemodynamic stress, systemic inflammation and hypercoagulability.18, 19 High NT-proBNP was associated not only with a high risk of pulmonary oedema but also with AMI and primary cardiovascular death in our study. This evidence concerns the gene NPPB and pulmonary edema.