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The objective of this study was to formulate a prediction model based on laboratory assessments and clinical parameters, providing additional guidance and insight into this relatively unexplored aspect of post-TAVI complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The present study was an observational prospective hypothesis-generating study, including 101 patients who underwent TAVI and a screening for LT (the primary endpoint) by multidetector computed tomography (MDCT). All images were acquired on a third-generation dual-source CT system. Levels of von Willebrand factor (vWF) activity, hemoglobin (Hb), and lactate dehydrogenase (LDH) were measured among other parameters. A predictive score utilizing binary logistic regression, Kaplan\u2013Meier time-to-event analysis, and receiver operating characteristics (ROC) analysis was established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      LT (11 subclinical and 2 clinical) was detected in 13 of 101 patients (13%) after a median time to screening by MDCT of 105\u00a0days (IQR, 98\u2013129\u00a0days). Elevated levels of vWF activity (&gt;\u2009188%) pre-TAVI, decreased Hb values (&lt;\u200911.9\u00a0g\/dL), as well as increased levels of LDH (&gt;\u2009312 U\/L) post-TAVI and absence of oral anticoagulation (OAC) were found in patients with subsequent LT formation as compared to patients without LT. The established EFFORT score ranged from\u2009\u2212\u20091 to 3 points, with an increased probability for LT development in patients with\u2009\u2265\u20092 points (85.7% of LT cases) vs\u2009&lt;\u20092 points (14.3% of LT cases;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Achieving an EFFORT score of\u2009\u2265\u20092 points was found to be significantly associated with a 10.8 times higher likelihood of developing an LT (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). The EFFORT score has an excellent c-statistic (area under the curve (AUC)\u2009=\u20090.89; 95% CI 0.74\u20131.00;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and a high negative predictive value (98%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An EFFORT score might be a helpful tool to predict LT development and could be used in risk assessment, if validated in confirmatory studies. Therefore, the score has the potential to guide the stratification of individuals for the planning of subsequent MDCT screenings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                    <jats:p>Central illustration. 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Steiner-Gager: none. Jovan Rogozarski: none. Christina Kronberger: none. Al Medina Dizdarevic: none. Peter Quehenberger: none. Ruediger Schernthaner: none. Christian Loewe: none. Lukas Reider: none. Andreas Strassl: none. Katarina Kovacevic Miljevic: none. Bernd Jilma: none. Cihan Ay: personal fees for lectures and\/or participation in advisory boards from Bayer, BMS, Daiichi-Sankyo, Pfizer, and Sanofi. Oliver K\u00f6nigsbr\u00fcgge: Advisory board honoraria: BMS, Pfizer, CSL Behring. Marek Postula: none. Christian Hengstenberg: none. Jolanta Siller-Matula: personal fees for lectures and\/or participation in advisory boards from Daiichi-Sankyo, Chiesi, and Cordis within the last 2\u00a0years.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"LT formation in patients after TAVI is associated with an increased risk for stroke.Integrating the EFFORT score into the conventional post-TAVI regimen could offer a viable strategy to identify patients who would benefit from a MDCT scan within 3 to 4\u00a0months post-procedure. Future validation of the EFFORT score in an independent study cohort could provide additional guidance and insight into this relatively unexplored aspect of post-TAVI complications.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Impact on daily practice"}}]}}