CHADS2-VASc Score: Stroke Risk Assessment In A. Fib.

CHA₂DS₂-VASc Score: Stroke Risk Assessment in
Non-valvular Atrial Fibrillation
(Risk factor-based scoring system)

Condition / Points

C: Congestive heart failure (or Left ventricular systolic dysfunction) (Points: 1 )

H: Hypertension: (Points: 1 )

A₂: Age 75 years (Points: 2 )

D: Diabetes Mellitus (Points: 1 )

S₂: Prior Stroke or TIA or thromboembolism (Points: 2 )

V: Vascular disease (previous MI, peripheral arterial disease or aortic plaque)
(Points: 1 )

A: Age 65-74 years (Points: 1 )

Sc: Sex category ( female gender) (Points: 1 )

Background

CHA₂DS₂-VASc score^1,2: Clinical prediction rule for assessing the risk of stroke in patients with non-valvular atrial fibrillation. The result can be used to determine whether or not treatment is required with anticoagulation therapy or antiplatelet therapy. A high CHA₂DS₂VASc Score corresponds to a greater risk of stroke, while a low CHA₂DS₂-VASc score corresponds to a lower risk of stroke. The CHA2DS2-VASc score is a refinement of CHADS2 score and extends the latter by including additional common stroke risk factors.
The maximum CHADS₂ score is 6, while the maximum CHA₂DS₂-VASc score is 9.

	Condition	Points
C	Congestive heart failure (or Left ventricular systolic dysfunction)	1
H	Hypertension: blood pressure consistently above 140/90 mmHg (or treated hypertension on medication)	1
A₂	Age 75 years	2
D	Diabetes Mellitus	1
S₂	Prior Stroke or TIA or thromboembolism	2
V	Vascular disease (previous MI, peripheral arterial disease or aortic plaque)	1
A	Age 65-74 years	1
Sc	Sex category ( female gender)	1

References:
[1 ] Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, Van Gelder IC, Al-Attar N, Hindricks G, Prendergast B, Heidbuchel H, Alfieri O, Angelini A, Atar D, Colonna P, De Caterina R, De Sutter J, Goette A, Gorenek B, Heldal M, Hohloser SH, Kolh P, Le Heuzey JY, Ponikowski P, Rutten FH. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010 Oct;31(19):2369-429..

[2 ] 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 Feb; 137(2):263-72.

[3 ] Lip GY, Frison L, Halperin J, Lane D. Identifying patients at risk of stroke despite anticoagulation. Stroke 2010

[ 4 ] Olesen JB, Lip GY, Hansen ML, Hansen PR, Tolstrup JS, Lindhardsen J, Selmer C, Ahlehoff O, Olsen AM, Gislason GH, Torp-Pedersen C. Validation of risk stratification schemes for predicting stroke and thromboembolism in patients with atrial fibrillation: nationwide cohort study. BMJ. 2011 Jan 31;342:d124. doi: 10.1136/bmj.d124.