Smilowitz NR, Redel-Traub G, Berger JS, et al. - As macrovascular atherosclerotic disease and risk factors remain the focus of contemporary approaches to cardiovascular risk stratification before noncardiac surgery, researchers here examined the prevalence of microvascular disease (MVD; retinopathy, neuropathy, and nephropathy) and its linked perioperative outcomes. Using the Nationwide Inpatient Sample, they identified 81,297,003 hospitalizations for noncardiac surgery. Among these, 4,236,932 (5.0%) had a diagnosis of MVD. This suggests the presence of microvascular disease in 1 in 20 hospitalizations for noncardiac surgery. Patients with microvascular disease were noted to be older and had more cardiovascular risk factors. Further, microvascular disease was noted to be linked with perioperative mortality and major adverse cardiac events (MACE; death, myocardial infarction, and ischemic stroke) independent of macrovascular disease and traditional risk factors.