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. The gene discussed is NPPB; the disease is thrombophilia.