CHA2DS2-VASc Score

The CHA2DS2-VASc score is used for risk stratification of ischemic stroke and thromboembolism in patients with atrial fibrillation. Based on this, the necessity of therapeutic anticoagulation can be estimated. This score is a further development and improvement of the CHADS2 score.
To assess the 1-year risk of major bleeding in patients with atrial fibrillation, the HAS-BLED score can be used.

Congestive heart failure or left ventricular dysfunction
Hypertension
treated or untreated
Age
Diabetes mellitus
Previous Stroke, transient ischemic attacks, or thromboembolism
Vascular disease
previous myocardial infarction, peripheral arterial disease, or aortic plaque
Sex

CHA2DS2-VASc Score:

  • Ischemic stroke:
  • Thromboembolism:

Recommendation:

Interpretation
Points Risk for ischemic stroke Risk for thromboembolism Recommendation
0 0.2 % 0.2 %

Low risk for ischemic stroke and thromboembolism

Anticoagulation rather not required
1 0.6 % 0.9 %

Intermediate risk for ischemic stroke and thromboembolism

Consider anticoagulation
2 2.2 % 2.9 %

High risk of ischemic stroke and thromboembolism

Anticoagulation recommended
3 3.2 % 4.6 %
4 4.8 % 6.7 %
5 7.2 % 10 %
6 9.7 % 13.6 %
7 11.2 % 15.7 %
8 10.8 % 15.2 %
9 12.2 % 17.4 %
References
  1. Lip GY, Nieuwlaat R, Pisters R et al. 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
  2. Friberg L, Rosenqvist M, Lip GY. Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182 678 patients with atrial fibrillation: the Swedish Atrial Fibrillation cohort study. Eur Heart J 2012; 33: 1500-1510
  3. Hindricks G, Potpara T, Dagres N et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J 2020:

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