Jarai 2011.

Study characteristics
General information	Objective  Added biomarkers      Journal American Journal of Cardiology Country Austria Study design Prospective cohort study
Participants	Number of included patients 198 Surgical specialty Vascular surgery Age Mean 69 years (SD 9 years) Male sex 78.8% High‐risk surgery 82.3%   Insulin‐dependent diabetes mellitus Not reported History of ischaemic heart disease Not reported  History of congestive heart failure 5.1% History of cerebrovascular events 17.7% Elevated creatinine 0% 0 RCRI factors 64.1% 1 or more RCRI factors 35.9%
Predictors	Predictor 1: Copeptin Objective: added biomarker Category: blood Scale: dichotomous Threshold: 14 mg/dL Assay/device: chemiluminescence assay (Brahms AG, Hennigsdorf, Germany)   Predictor 2: NT‐proBNP + copeptin Objective: added biomarker Category: blood Scale: dichotomous Threshold: 280 pg/mL and 14 mg/dL, respectively Assay/device: chemiluminescence assay (Brahms AG, Hennigsdorf, Germany)
Outcome	Outcome category MACE Full outcome definition Cardiac death, nonfatal myocardial infarction and emergent coronary artery revascularisation Prediction horizon 24 to 30 months after surgery
Analysis	Number of outcomes 40       Handling missing data No information on handling missing data Discrimination reported? No Calibration reported? No   Reclassification reported? Yes
PROBAST: Applicability	Domain 1: Participant selection Low Justification:  Domain 2: Predictors High Justification: preoperative creatinine was deleted from the model as all patients with creatinines > 1.4 were excluded Domain 3: Outcome High Justification: the outcome definition differed from the MACE definition in the development study Overall judgement High Justification: patient selected were generalisable to the patient population used in the RCRI development study. There was no/unclear information on predictor definitions and outcome definition was different compared to the RCRI development study.
Notes	—
Item	Authors' judgement	Support for judgement
Domain 1: Participant selection	No	Excluded were patients with acute coronary syndromes or evidence of myocardial ischaemia on stress tests (n = 4), decompensated heart failure (n = 2), aortic stenosis (n   2), atrial fibrillation (n = 17), kidney dysfunction (serum creatinine  1.4 mg/dl; n = 26), reduced left ventricular function (left ventricular ejection fraction 40%; n = 10)
Domain 2: Predictors	No	Preoperative creatinine was deleted from the model as all patients with creatinines > 1.4 were excluded
Domain 3: Outcome	No	Independent cardiologist had access to all available documents and clinical charts of each patient.
Domain 4:  Analysis	No	Low number of outcomes, dichotomisation of predictors and no handling of missing data.
Overall judgement	No	Patient selection and outcome and predictor definitions/assessments were inappropriate. In addition, the number of outcomes was low, there was no information on the handling of missing data and predictors were dichotomised.