Cellular precOnditioning for Post-Surgical Myocardial Ischemic Complications - Observational Study

Inclusion Criteria: A participant must meet all 5 inclusion criteria to be eligible: * Referred for elective intermediate to high risk noncardiac surgery as defined by the American Heart Association guidelines (e.g., intrathoracic, open intraabdominal, or open vascular surgery) * 45 years of age or older * Revised cardiac risk index ≥ 2 * NT-proBNP level of ≥ 200 pg/mL * Able to provide informed consent Exclusion Criteria: * Experience an acute coronary syndrome, myocardial infarction, heart failure, or stroke within preceding 3 months * Coronary revascularization anticipated during the study period * Severe mitral/aortic valve stenosis * Evidence of clinically significant arrhythmia in last three months. * Major surgical procedure in previous 3 months * History of malignancy requiring surgery, chemotherapy, immunotherapy, or radiation within previous 5 years * Ongoing malignancy requiring surgical resection * Women who are pregnant, breastfeeding, or of childbearing potential who are unable to use a medically acceptable form of contraception throughout the study * Received any experimental cell therapy previously * Unable to provide written informed consent