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
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
cha2ds2-vasc.txt · Last modified: 2014/04/04 16:20 (external edit)