Based on this evidence, the 2017 Canadian Cardiovascular Society Guidelines have strongly recommended BNP or NT-proBNP measurement before surgery to refine perioperative cardiac risk estimation in patients: (1) older than 65 years; (2) aged 45–64 years with cardiovascular disease; (3) with a Revised Cardiac Risk Index (RCRI) score > 1 [13]. The gene discussed is NPPB; the disease is cardiovascular disorder.