Atrial Fibrillation CHA(2)DS(2)-VASc Score for Stroke Risk

 

Clinical Features
		Congestive heart failure / LV dysfunction (1 point)
		Hypertension (1 point)
		Diabetes Mellitus (1 point)
		History of stroke, TIA or thromboembolism (2 points)
		Vascular disese (history of MI, PVD or aortic atherosclerosis) (1 point)
Age
		65-74 years old (1 point)
		≥75 years old (2 points)
Sex
		Female (1 point)
		Male (0 points)

 

Total Criteria Point Count:
 

 

Adjusted Stroke Rate

 

0 points:	0% per year
1 point:	1.3% per year
2 points:	2.2% per year
3 points:	3.2% per year
4 points:	4% per year
5 points:	6.7% per year
6 points:	9.8% per year
7 points:	9.6% per year
8 points:	6.7% per year
9 points:	15.2% per year

 

Notes

• The Lip-Halperin article seeks to improve stroke risk stratification of the CHADS(2) score by adding more points for age >=75 and Vascular disease.
• The article suggests aspirin or no treatment for a score of 0, and oral anticoagulation when the score is 2 or greater.
• The adjusted stroke risk figures are found in the AHA/ACC/HRS Guideline listed below.

 

References

1. Cairns JA. ACP journal club. CHA2DS2-VASc had better discrimination than CHADS2 for predicting risk for thromboembolism in atrial fibrillation. Ann Intern Med. 2011 May 17;154(10):JC5-13. doi: 10.1059/0003-4819-154-10-201105170-02013. PubMed ID: 21576531
2. Olesen JB, Lip GY, Hansen ML, et al. 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. PubMed ID: 21282258
3. January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014 Mar 28. pii: S0735-1097(14)01740-9. PubMed ID: 24685669
4. Lip GY, Halperin JL. Improving stroke risk stratification in atrial fibrillation. Am J Med. 2010 Jun;123(6):484-8. Review. PubMed ID: 20569748
5. Gage BF, Andrade A. ACP Journal Club. Various risk stratification schemes predict ischemic stroke and bleeding in atrial fibrillation. Ann Intern Med. 2012 Oct 16;157(8):JC4-13. doi: 10.7326/0003-4819-157-8-201210160-02013. PubMed ID: 23070515
6. 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 Jun;33(12):1500-10. doi: 10.1093/eurheartj/ehr488. Epub 2012 Jan 13. PubMed ID: 22246443