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Generalist clinicians often are asked to formally assess patients' cardiac risk prior to surgery. The 2014 American College of Cardiology/American Heart Association guidelines on perioperative cardiovascular evaluation recommend using functional status (expressed in METs [metabolic equivalent of task]) plus a validated clinical risk score to guide risk stratification (NEJM JW Gen Med Dec 1 2014 and J Am Coll Cardiol 2014; 64:77). However, recent evidence has cast doubt on the prognostic value of self-reported functional status (NEJM JW Gen Med Dec 15 2018 and Lancet 2018; 391:2631) and has suggested that measuring preoperative N-terminal pro–B-type natriuretic peptide (NT-proBNP) can improve prediction of adverse cardiac outcomes (NEJM JW G…