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Clinical data, biomarker information, and transthoracic echocardiographic parameters were collected in a standardized manner. The derivation cohort comprised patients from one center, while the validation cohort consisted of participants from the other center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>1505 patients (mean age 63.4\u00b19.77 years; 895 male) were analyzed. LAAT was detected in 109 (7.24%) of the total 1505 patients. The final parameters selected for the LEFT-AF risk model included left atrial diameter (LAD), left ventricular ejection fraction (LVEF), history of heart failure (HF), history of stroke, and non-paroxysmal AF (NPAF). In the derivation cohort, the novel scoring system demonstrated superior discriminative performance compared to the currently used CHA2DS2-VASc score (0.693, 95% CI 0.634-0.752) (P&lt;0.001), CHA2DS2 score (0.679, 95% CI 0.621-0.731) (P&lt;0.001) and CLOTS-AF score (Creatinine&gt;1.5mg\/dL, LVEF&lt;50%, LAVI&gt;34ml\/m2, TAPSE&lt;17mm, Stroke, AF rhythm) (0.762, 95% CI 0.704-0.821), with an area under the receiver operating characteristic curve (AUC) of 0.855 (95% CI 0.808-0.902) (P&lt;0.001). This same superior performance was maintained in the validation cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among patients with NVAF who had not previously received anticoagulation therapy, the prevalence of LAAT was 7.24%. The LEFT-AF score improves LAAT risk stratification, particularly in patients with low CHA2DS2-VASc scores, potentially guiding anticoagulation decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s12872-025-05348-6","type":"journal-article","created":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T05:54:17Z","timestamp":1766210057000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A new risk-stratified scoring system for predicting left atrial appendage thrombus in patients with nonvalvular atrial fibrillation"],"prefix":"10.1186","volume":"26","author":[{"given":"Junhao","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuefeng","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaobo","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengmeng","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyan","family":"Jing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongxia","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,20]]},"reference":[{"issue":"2","key":"5348_CR1","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1016\/0735-1097(94)00396-8","volume":"25","author":"MF Stoddard","year":"1995","unstructured":"Stoddard MF, Dawkins PR, Prince CR, Ammash NM. 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