Prediction model for leaflet thrombosis in patients undergoing transcatheter aortic valve implantation: the EFFORT study

作者：Gloria M. Steiner‐Gager, Jovan Rogozarski, Christina Kronberger, Al Medina Dizdarevic, Peter Quehenberger, Ruediger E. Schernthaner, Christian Loewe, Lukas Reider, Andreas Strassl, Katarina Kovacevic Miljevic, Bernd Jilma, Cihan Ay, Oliver Königsbrügge, Marek Postuła, Christian Hengstenberg, Jolanta M. Siller‐Matula · 发表于：Clinical Research in Cardiology · 年份：2024 · DOI：10.1007/s00392-024-02486-3 · 被引用次数：4 · 研究领域：Cardiac Valve Diseases and Treatments、Pulmonary Hypertension Research and Treatments、Venous Thromboembolism Diagnosis and Management

BACKGROUND: Leaflet thrombosis (LT) is a multifaceted and underexplored condition that can manifest following transcatheter aortic valve implantation (TAVI). 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. METHODS: 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-Meier time-to-event analysis, and receiver operating characteristics (ROC) analysis was established. RESULTS: LT (11 subclinical and 2 clinical) was detected in 13 of 101 patients (13%) after a median time to screening by MDCT of 105 days (IQR, 98-129 days). Elevated levels of vWF activity (> 188%) pre-TAVI, decreased Hb values (< 11.9 g/dL), as well as increased levels of LDH (> 312 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 - 1 to 3 points, with an increased probability f...