{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T16:10:22Z","timestamp":1778343022870,"version":"3.51.4"},"reference-count":73,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,4,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with chronic kidney disease are at high risk of adverse outcomes after acute coronary syndrome (ACS) and need optimized treatment decisions. We derived and validated a series of risk models for predicting 1\u2010year mortality, readmission for myocardial infarction, and progression to kidney failure following ACS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">The development cohort included adults with chronic kidney disease who had an admission for non\u2010ST\u2010segment\u2013elevation ACS, in Alberta, Canada between April 1, 2004 and March 31, 2017. Cox proportional hazard and Fine and Gray competing risk models were externally validated and updated in a temporally distinct cohort of patients in Alberta and a geographically distinct cohort of patients with chronic kidney disease and ACS in British Columbia, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">The derivation cohort included 11\u2009980 patients, the temporal validation cohort 4204, and the geographic validation cohort 1787. All models showed comparable discrimination and calibration in the temporal validation cohort; comparable model performance was achieved in the geographic validation cohort after updating. In the temporal and geographic validation cohorts, respectively, discrimination was very good for kidney failure (C\u2010indexes, 0.93 [95% CI, 0.89\u20130.97] and 0.80 [95% CI, 0.78\u20130.82]), and modest for mortality (0.77 [95% CI, 0.75\u20130.78] and 0.71 [95% CI, 0.69\u20130.73]), and readmission for myocardial infarction (0.65 [95% CI, 0.62\u20130.67] and 0.57 [95% CI, 0.53\u20130.62]). All models were well calibrated after updating.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">We have developed, validated, and updated risk models for cardiac and renal outcomes in patients with chronic kidney disease and ACS, which can help facilitate shared decision\u2010making surrounding diagnostic testing, treatment, and monitoring of these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.045139","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T10:08:10Z","timestamp":1775556490000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Derivation and Validation of Risk Prediction Models for Cardiovascular and Kidney Outcomes of Non\u2010ST\u2010Segment\u2013Elevation Acute Coronary Syndrome in Patients With Chronic Kidney Disease"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4345-0146","authenticated-orcid":false,"given":"Todd A.","family":"Wilson","sequence":"first","affiliation":[{"name":"University of Calgary","place":["Calgary, Canada"]},{"name":"University of Calgary","place":["Calgary, Canada"]},{"name":"University of Calgary","place":["Calgary, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee","family":"Er","sequence":"additional","affiliation":[{"name":"BC Renal","place":["Vancouver, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5696-5552","authenticated-orcid":false,"given":"Tolulope T.","family":"Sajobi","sequence":"additional","affiliation":[{"name":"University of Calgary","place":["Calgary, Canada"]},{"name":"University of Calgary","place":["Calgary, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6344-312X","authenticated-orcid":false,"given":"Stephen B.","family":"Wilton","sequence":"additional","affiliation":[{"name":"University of Calgary","place":["Calgary, Canada"]},{"name":"University of Calgary","place":["Calgary, Canada"]},{"name":"University of Calgary","place":["Calgary, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7709-3741","authenticated-orcid":false,"given":"Glen S.","family":"Hazlewood","sequence":"additional","affiliation":[{"name":"University of Calgary","place":["Calgary, Canada"]},{"name":"University of Calgary","place":["Calgary, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Birks","sequence":"additional","affiliation":[{"name":"University of British Columbia","place":["Vancouver, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2438-8401","authenticated-orcid":false,"given":"Adeera","family":"Levin","sequence":"additional","affiliation":[{"name":"University of British Columbia","place":["Vancouver, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0708-7957","authenticated-orcid":false,"given":"Michelle M.","family":"Graham","sequence":"additional","affiliation":[{"name":"University of Alberta","place":["Edmonton, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2760-8967","authenticated-orcid":false,"given":"Bryan","family":"Har","sequence":"additional","affiliation":[{"name":"University of Calgary","place":["Calgary, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1876-3917","authenticated-orcid":false,"given":"Matthew T.","family":"James","sequence":"additional","affiliation":[{"name":"University of Calgary","place":["Calgary, Canada"]},{"name":"University of Calgary","place":["Calgary, Canada"]},{"name":"University of Calgary","place":["Calgary, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","unstructured":"Go AS Chertow GM Fan D McCulloch CE Hsu CY. 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