This is a case-control study in patients undergoing major, non-cardiac surgery. Permission will be obtained from the Ethics committee prior to patient recruitment and Good Clinical Practice guidelines will be followed in all patients. Verbal and written informed consent will be obtained from all patients willing to participate in the study. The study will be registered in an international database before start of patient recruitment. Patients would be assessed for inclusion in the preoperative anaesthetic clinic and a detailed preoperative history taken and examination performed to exclude myocardial ischemia or heart failure. The following laboratory tests would be performed preoperatively (baseline values): routine bloods, creatinine, urea, estimated glomerular filtration rate (eGFR), C-reacting proteins (CRP), white blood cell (WBC) count, TnT, N-Terminal pro-Brain Natriuretic Peptide (NT-pro BNP), lipid profile, 12-lead EKG and echocardiography (ECHO).