CHA2DS2-VASc Score
Editors-in-Chief: Gregory Lip, MD [1] and C. Michael Gibson, M.S., M.D. [2]
Overview
The CHA2DS2-VASc score predicts clinical risk of stroke and thromboembolism in atrial fibrillation[1].
| Feature | Score if present |
|---|---|
| Congestive Heart Failure | 1 |
| Hypertension | 1 |
| Age ≥ 75 years | 2 |
| Age between 65 and 74 years | 1 |
| Stroke/TIA/TE | 2 |
| Vascular disease (previous MI, peripheral arterial disease or aortic plaque) | 1 |
| Diabetes mellitus | 1 |
| Female | 1 |
Anticoagulation based on the CHA2DS2-VASc score
The following treatment strategies are recommended in the table below entitled Anticoagulation based on the CHADS2 score:[2][3]
| Score | Risk | Anticoagulation Therapy | Considerations |
|---|---|---|---|
| 0 | Low | Aspirin | Aspirin daily |
| 1 | Moderate | Aspirin or Warfarin | Aspirin daily or INR to 2.0-3.0, depending on factors such as patient preference |
| 2 or greater | Moderate or High | Warfarin | INR to 2.0-3.0, unless contraindicated (e.g. clinically significant GI bleeding, inability to obtain regular INR screening) |
Assessment of Bleeding Risk with Anticoagulation
The decision to anticoagulate a patient should also be based upon an assessment of the risk of bleeding using a score such as the HAS-BLED score.
REFERENCES
- ↑ Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest. 2010 Feb; 137(2):263-72.(Link to article – subscription may be required.)
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