Home/Calculators/CHA2DS2-VASc

CHA2DS2-VASc

Estimates stroke risk in atrial fibrillation for anticoagulation decisions

When to Use

  • Patients with non-valvular atrial fibrillation (AF)
  • Decision-making for oral anticoagulation initiation
  • Perioperative anticoagulation management in AF patients

When NOT to Use

  • Patients with mechanical heart valves (always need warfarin)
  • Moderate-severe mitral stenosis (use warfarin, not DOACs)
  • Not for stroke risk in the absence of AF
Running Total0 / 9
Congestive Heart Failure (or LVEF <= 40%)(1 point)
Hypertension (resting BP > 140/90 or on treatment)(1 point)
Age
Diabetes Mellitus(1 point)
Prior Stroke, TIA, or Thromboembolism(2 points)
Vascular disease (prior MI, peripheral artery disease, aortic plaque)(1 point)
Female sex(1 point)

Annual Stroke Risk by Score

Score 0
0.2% / year
Score 1
0.6% / year
Score 2
2.2% / year
Score 3
3.2% / year
Score 4
4.8% / year
Score 5
7.2% / year
Score 6
9.7% / year
Score 7
11.2% / year
Score 8
10.8% / year
Score 9
12.2% / year

Evidence & References

  • Lip GYH, Nieuwlaat R, Pisters R, Lane DA, Crijns HJGM. 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(2):263-272.PMID: 19762550
  • Hindricks G, Potpara T, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation. Eur Heart J. 2021;42(5):373-498.PMID: 32860505
  • Douketis JD, Spyropoulos AC, et al. Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation (BRIDGE Trial). N Engl J Med. 2015;373(9):823-833.PMID: 26095867
Disclaimer: This calculator is a clinical decision aid and does not replace clinical judgment. Always consider the full clinical context when making patient care decisions.