What is CHA₂DS₂-VASc?
CHA₂DS₂-VASc estimates stroke risk in non-valvular atrial fibrillation. It guides anticoagulation.
Points
| Criterion | Points |
|---|
| C | Congestive heart failure | 1 |
| H | Hypertension | 1 |
| A₂ | Age 75 or over | 2 |
| D | Diabetes | 1 |
| S₂ | Stroke, TIA or thromboembolism | 2 |
| V | Vascular disease | 1 |
| A | Age 65 to 74 | 1 |
| Sc | Sex category: female | 1 |
NICE NG196 advice
- Score 0: anticoagulation not recommended.
- Score 1 in men: consider anticoagulation.
- Score 2 or more: offer anticoagulation, with a DOAC first line.
- Female sex alone does not justify anticoagulation.
Assess bleeding risk with ORBIT. Dose DOACs using creatinine clearance.
Frequently asked questions
What CHA2DS2-VASc score needs anticoagulation?
NICE advises offering anticoagulation at 2 or more, and considering it in men with a score of 1.
Does female sex count?
It adds 1 point, but female sex alone is not a reason to anticoagulate.
Is CHADS-VASc the same as CHA2DS2-VASc?
Yes. It is a common shorthand for the same score.
References
- Lip GY, Nieuwlaat R, Pisters R, et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation. Chest 2010;137(2):263–72.
- NICE. Atrial fibrillation: diagnosis and management. NG196. nice.org.uk/guidance/ng196
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