CHA2DS2-VASc score

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The CHA2DS2-VASc score predicts clinical risk of stroke and thromboembolism in atrial fibrillation[1].

CHA2DS2-VASc score for stroke risk in atrial fibrillation
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

Before bleeding risk evaluated score of 0 recommends no antithrombotic therapy and 2 or more antithrombotic therapy. A score of 1 recommends either antithrombotic or antiplatelet therapy. Consider a risk of bleeding assessment such as the HAS-BLED score before anticoagulation.

LogoKeyPointsBox.pngIt is always important to understand with a score what is excluded. This score is for non-valvular atrial fibrillation. For example the evidence base for anticoagulation with mitral stenosis and atrial fibrillation was well defined years ago and so this score excluded such patients, most of whom are at high risk of stroke so should be offered anticoagulation

Score validation

Developed on the same principles as the CHADS2 score it considers additional stroke risk factors and gives age a higher weighing. This results in better discrimination between high and low risk patients[2].

References

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