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CHADS2 Score
Stroke risk stratification in non-valvular atrial fibrillation — guides anticoagulation
Cardiology
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Clinical reference only. Not a substitute for professional medical judgment. Verify all results against institutional protocols before clinical use.
Calculate
CHADS2 has been largely replaced by CHA2DS2-VASc for most patients. Always integrate bleeding risk (HAS-BLED) before initiating anticoagulation.
Formula
CHADS2 = CHF(1) + HTN(1) + Age≥75(1) + Diabetes(1) + Stroke/TIA(2)
CCongestive heart failure (1 point)
HHypertension (1 point)
AAge ≥ 75 years (1 point)
DDiabetes mellitus (1 point)
S₂Prior Stroke or TIA (2 points)
When to Use
Atrial fibrillation: decide whether to initiate oral anticoagulation. Best used alongside bleeding risk assessment.
Clinical Pearls
- •CHADS2 was validated in patients with non-valvular AF — does not apply to valvular AF (e.g. mitral stenosis).
- •Score ≥2 is the usual threshold for anticoagulation in guidelines.
- •CHA2DS2-VASc is now preferred (see CHA2DS2-VASc calculator) as it reclassifies more patients accurately.
- •In Indian patients, rheumatic mitral stenosis + AF is common — these patients need anticoagulation regardless of score.
Original Publication
Gage BF (2001). JAMA.