Determining the optimal timing for noncardiac surgery in patients with underlying ischemic heart disease, particularly after recent myocardial infarction (MI), is challenging. The ACC/AHA guidelines recommend delaying noncardiac surgery for more than 60 days after an MI treated without coronary intervention and 365 days after drug-eluding stent (DES) implantation. Noncardiac surgery can be considered after 180 days from DES but with the caveat that dual-antiplatelet therapy should not be discontinued perioperatively.1