CHA2DS2-VASc Score Calculator
Calculate stroke risk in atrial fibrillation patients using the CHA2DS2-VASc scoring system to guide anticoagulation therapy decisions.
What is the CHA2DS2-VASc score used for?
The CHA2DS2-VASc score is used to estimate stroke risk in patients with atrial fibrillation (AFib). It helps clinicians decide whether anticoagulation therapy is needed. Score ranges 0-9, with higher scores indicating greater stroke risk. Score 0 (males) or 1 (females) = low risk, score 1 (males) = moderate risk, score >=2 = high risk requiring anticoagulation. It's more sensitive than older CHADS2 score, especially for identifying low-risk patients.
How is the CHA2DS2-VASc score calculated?
Points are awarded as follows: Congestive heart failure (1 point), Hypertension (1), Age >=75 (2), Diabetes (1), Stroke/TIA history (2), Vascular disease (1), Age 65-74 (1), Sex category female (1). Maximum score is 9. The acronym helps remember: C=CHF, H=Hypertension, A2=Age>=75 (doubled), D=Diabetes, S2=Stroke (doubled), V=Vascular disease, A=Age 65-74, Sc=Sex category.
What CHA2DS2-VASc score requires anticoagulation?
Guidelines recommend: Score 0 (men) or 1 (women, due to sex point) = low risk, no anticoagulation needed unless patient preference. Score 1 (men) = consider anticoagulation, discuss risks/benefits. Score >=2 = oral anticoagulation recommended (warfarin or DOACs like apixaban, rivaroxaban, dabigatran). Always consider bleeding risk using HAS-BLED score before starting anticoagulation.
Is CHA2DS2-VASc better than CHADS2?
Yes, CHA2DS2-VASc is superior for risk stratification. It includes additional risk factors (vascular disease, age 65-74, female sex) making it more comprehensive. Better identifies truly low-risk patients (score 0) who don't need anticoagulation. CHADS2 classified many patients as "intermediate risk" (score 1-2), while CHA2DS2-VASc provides better discrimination. Current guidelines prefer CHA2DS2-VASc for AFib stroke risk assessment.
What are limitations of CHA2DS2-VASc score?
Limitations include: Doesn't account for bleeding risk (use HAS-BLED separately), based on population studies (individual risk varies), doesn't consider other factors like kidney disease severity or frailty. Female sex adds point, but controversy exists about whether this truly increases risk independent of age. Score should guide, not dictate treatment - clinical judgment and patient preferences matter. Not validated for patients with mechanical heart valves or severe mitral stenosis.