European Society of Cardiology (ESC)/ European Society of Anesthesiology (ESA) highlighted that anesthesiologist has a leading role in perioperative cardiovascular assessment and management in the year of 2014. During cardiovascular assessment one can rely on cooperation of multidisciplinary specialists like: other anesthesiologists, cardiologists and surgeons. For the purpose of precise systematization and decision making the Lee Score or NSQUIP database can be used besides the traditionally used ASA Score. Additional help is provided with specific palette of cardiac biomarkers like: cardiac troponins T, cardiac troponins I, C-reactive protein, N-terminal pro-brain natriuretic peptide, brain natriuretic peptide, etc. Biomarkers are considered to represent a foundation of evidence based medicine and they help anesthesiologists in the decision-making process. They increase the chance to achieve the best clinical outcome for each patient. An ideal biomarker does not exist and therefore new research are currently being conducted with the aim to find and declare more specific biomarkers like heart-type fatty acid-binding protein, micro RNA, PAMP and high sensitivity troponins T.