Race Original cohort Clean cohort HR 95%CI P HR 95%CI P. <8.5 White Black

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1 Appendix Table 1: Hazard Ratios of the association between CSCs and all-cause mortality from original cohort and the clean cohort excluding CHD/strokes. CSC categories Race Original cohort Clean cohort HR 95%CI P HR 95%CI P <8.5 White Black <8.8 White Black <9.1 White Black <9.4 White Black <9.7 White Black <10.0 White Black <10.3 White Black White Black

2 Electronic appendix Appendix Figure 1: Race -specific associations of CSC with mortality in the PS-matched cohort: Multivariable adjusted hazard ratios (95% confidence intervals) of all-cause mortality associated with African American and white race in various mean baseline CSC categories using multivaribale adjusted Cox models in a PS-matched cohort. Adjustment were made for age, gender, income, BMI, marital status,, comorbidities, medications, baseline estimated GFR, and baseline blood pressures. White patients with CSC 9.1-[lt]9.4 mg/dl served as referent. Models included a multiplicative interaction term for race and CSC. Signficant differences foraa vs. white in the CSC categories marked with * are [lt] Appendix Figure 2: The association of CSC with mortality in race subgroups: Multivariable adjusted hazard ratios (95% confidence intervals) of all-cause mortality associated with various mean baseline corrected serum calcium categories in separate race subgroups. Results were obtained from Cox models adjusted for age, gender, income, BMI, marital status,, comorbidities, medications, baseline estimated GFR, and baseline blood pressures. Patients with CSC 9.1-[lt]9.4 mg/dl served as referent in both subgroups. Appendix Figure 3: Race-specific associations of CSC with mortality using more granular serum calcium categories in the overall cohort: Multivariable adjusted hazard ratios (95% confidence intervals) of all-cause mortality associated with African American and white race in various mean baseline CSC categories using multivaribale adjusted Cox models. Adjustment were made for age, gender, income, BMI, marital status, comorbidities, medications, baseline estimated GFR, and baseline blood pressures. White patients with CSC 9.1-[lt]9.4 mg/dl served as referent. Models included a multiplicative interaction term for race and CSC. Appendix Figure 4: Race -specific associations of CSC with CHD in the PS-matched cohort: Multivariable adjusted hazard ratios (95% confidence intervals) of the incident CHD (including incident acute MI, coronary artery bypass grafting, or PCI) associated with African American and white race in various mean baseline CSC categories using multivaribale adjusted Cox models in a PS-matched cohort. Adjustment were made for age, gender, income, BMI,

3 marital status,, comorbidities, medications, baseline estimated GFR, and baseline blood pressures. White patients with CSC 9.1-[lt]9.4 mg/dl served as referent. Models included a multiplicative interaction term for race and CSC. Appendix Figure 5: Race -specific associations of CSC with ischemic stroke in the PSmatched cohort: Multivariable adjusted hazard ratios (95% confidence intervals) of the incident ischemic strokes associated with African American and white race in various mean baseline CSC categories using multivaribale adjusted Cox models in a PS-matched cohort. Adjustment were made for age, gender, income, BMI, marital status,, comorbidities, medications, baseline estimated GFR, and baseline blood pressures. White patients with CSC 9.1-[lt]9.4 mg/dl served as referent. Models included a multiplicative interaction term for race and CSC. Appendix Figure 6: Race -specific associations of CSC with CHD using more granular serum calcium categories in the overall cohort: Multivariable adjusted hazard ratios (95% confidence intervals) of the incident CHD (including incident acute MI, coronary artery bypass grafting, or PCI) associated with African American and white race in various mean baseline CSC categories using multivaribale adjusted Cox models. Adjustment were made for age, gender, income, BMI, marital status, comorbidities, medications, baseline estimated GFR, and baseline blood pressures. White patients with CSC 9.1-[lt]9.4 mg/dl served as referent. Models included a multiplicative interaction term for race and CSC. Appendix Figure 7: Race -specific associations of CSC with ischemic stroke using more granular serum calcium categories in the overall cohort: Multivariable adjusted hazard ratios (95% confidence intervals) of the incident ischemic strokes associated with African American and white race in various mean baseline CSC categories using multivaribale adjusted Cox models. Adjustment were made for age, gender, income, BMI, marital status,, comorbidities, medications, baseline estimated GFR, and baseline blood pressures. White patients with CSC 9.1-[lt]9.4 mg/dl served as referent. Models included a multiplicative interaction term for race and CSC.

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