🫀
CHA₂DS₂-VASc Score
Improved stroke risk score for AF — includes vascular disease, age 65–74, and female sex
Cardiology
⚕️
Clinical reference only. Not a substitute for professional medical judgment. Verify all results against institutional protocols before clinical use.
Calculate
Always integrate bleeding risk (HAS-BLED score) before initiating anticoagulation. This score applies to non-valvular AF only.
Formula
CHA₂DS₂-VASc = CHF(1) + HTN(1) + Age≥75(2) + DM(1) + Stroke(2) + Vascular(1) + Age65-74(1) + Female(1)
CCongestive heart failure / LV dysfunction (1)
HHypertension (1)
A₂Age ≥ 75 years (2)
DDiabetes mellitus (1)
S₂Prior Stroke / TIA / thromboembolism (2)
VVascular disease (MI, PAD, aortic plaque) (1)
AAge 65–74 years (1)
ScSex category female (1)
When to Use
Non-valvular atrial fibrillation — current standard of care for anticoagulation decision-making, endorsed by ESC, AHA/ACC.
Clinical Pearls
- •Female sex alone (score = 1) does not warrant anticoagulation per ESC 2020 guidelines.
- •DOACs (apixaban, rivaroxaban, dabigatran) preferred over warfarin for non-valvular AF.
- •In Indian patients: higher prevalence of rheumatic AF — these patients need anticoagulation regardless.
- •Score ≥2 in men, ≥3 in women = clear anticoagulation benefit per current guidelines.
Original Publication
Lip GY (2010). Chest.