Choi 2010.

Study characteristics
General information	Objective  Added biomarkers Journal Heart Country Republic of Korea Study design Prospective cohort study
Participants	Number of included patients 2054 Surgical specialty Noncardiac surgery Age Median 68 years (IQR = 61 to 73 years) Male sex 60.7% High‐risk surgery 41.1% Insulin‐dependent diabetes mellitus 3.5% History of ischaemic heart disease 21.6% History of congestive heart failure 3% History of cerebrovascular events 9.3% Elevated creatinine Not reported 0 RCRI factors 27% 1 RCRI factor 41.2% 2 RCRI factors 28.2% 3 or more RCRI factors 3.6%
Predictors	Predictor 1: NT‐proBNP Objective: added biomarkers Category: blood Scale: dichotomous Threshold: 301 mg/L Assay/device: not reported   Predictor 2: CRP Objective: added biomarkers Category: blood Scale: dichotomous Threshold: 3.4 mg/L Assay/device: not reported   Predictor 3: NT‐proBNP + CRP Objective: added biomarkers Category: blood Scale: dichotomous Threshold: 301 and 3.4 mg/L, respectively Assay/device: not reported
Outcome	Outcome category MACE; myocardial infarction; pulmonary oedema; cardiovascular death      Full outcome definition MACE was defined as myocardial infarction, development of pulmonary oedema or primary cardiovascular death. Cardiovascular death was defined as sudden death that could not be explained by any other than cardiovascular postoperative complications. Prediction horizon In‐hospital or within 30 days
Analysis	Number of outcomes 291 MACE      Handling missing data No information on handling missing data Discrimination reported? Yes Calibration reported? No  Reclassification reported? No
PROBAST: Applicability	Domain 1: Participant selection High Justification: patients were required to have ≥ 1 cardiovascular risk factor such as hypertension, diabetes, angina, history of revascularisation, heart failure or stroke, or abnormal preoperative electrocardiography with pathological Q wave or non‐sinus rhythm. In addition patients with creatinine > 2.0 mg/dL were excluded from the analysis.  Domain 2: Predictors Low Justification: not applicable Domain 3: Outcome Low Justification: not applicable Overall judgement High Justification: only a selected group of patients was included. However, predictors and outcomes were clearly defined and comparable as used in the development study.
Notes	—
Item	Authors' judgement	Support for judgement
Domain 1: Participant selection	Yes	Appropriate participant selection in which patients were selected in whom the RCRI model can be applied.
Domain 2: Predictors	Yes	Clear (RCRI) predictor definitions were described.
Domain 3: Outcome	Yes	Clearly defined outcome definitions and appropriate adjudication of outcomes.
Domain 4:  Analysis	No	Data were dichotomised for all predictors of interest; no information on the handling of missing data. No calibration or reclassification measures were reported.
Overall judgement	No	Appropriate patient selection and clearly defined predictors and outcomes. However, data were dichotomised, there was no information on the handling of missing data and no information on calibration and reclassification measures were reported.