CHA2DS2-VASc score for determining stroke risk in patients with non-valvular AF

scoring system

acronym stands for:
- Congestive heart failure/left ventricular dysfunction, Hypertension, Age ≥75 [doubled], Diabetes, Stroke [doubled] – Vascular disease, Age 65–74, and Sex category [female]).¹⁾
score 1 point for each item present, but 2 points for age > 74yrs and for PH stroke or TIA:

PH congestive cardiac failure

PH hypertension

age > 74 yrs

diabetes mellitus

PH stroke (CVA) or transient ischaemic attack (TIA)

PH vascular disease

age > 65-74 yrs

sex - female

risk of stroke in patients with AF

score	annual risk of stroke if no anticoagulation
0	0.8%
1	1.8%
2	2.7%
3	3.2%
4	4.0%
5	6.7%
6	9.8%
7	9.6% (yep less than score of 6!)
8	6.7% (yep less than score of 6 or 7!)
9	15.2%

most advise commencing anticoagulation in AF patients if CHA2DS2-VASc score is 2 or more and there are no significant C/I to warfarin - see antithrombotic Rx for prevention of stroke
those with a CHA2DS2-VASc score of 1 are “low-mod. risk” and should consider antiplatelet or anticoagulation Rx

¹⁾

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;137:263-272