ABSTRACTBackgroundPerioperative myocardial infarction (PMI) after noncardiac surgery results in significant morbidity and mortality. While comprehensive management, including imaging and guideline‐directed medical therapy (GDMT), improves outcomes, utilization of these strategies and the impact of physician evaluation on their utilization are unknown. This study evaluates the frequency of cardiology evaluation after PMI and its association with guideline‐recommended care.MethodsUsing IBM MarketScan (2016–2021), we analyzed claims for patients ≥ 45 years old with PMI during or after major noncardiac surgery. We examined the relationship between cardiology evaluation and post‐PMI care using three regression models: (1) a Poisson model for GDMT class prescriptions filled within 3 months post‐discharge, and logistic models for (2) ischemic testing and (3) echocardiography during hospitalization or within 3 months post‐discharge.ResultsAmong 5660 patients with PMI (mean age 68, 56.9% male, 27.2% with STEMI), 19% were not evaluated by a cardiologist. Patients with cardiology evaluation were more likely to receive at least one GDMT prescription after PMI (78.8% vs 74.0%, p < 0.001). Ca
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