What is the CHA2DS2-VASc Score?

The CHA₂DS₂-VASc score assigns points to a series of clinical observations in patients with non-valvular atrial fibrillation (AFIB). CHA₂DS₂-VASc scores are used to predict the risk of ischemic stroke.

The score is computed as follows:

• Congestive heart failure or left ventricular systolic dysfunction: 1 point
• Hypertension:  BP consistently above 140/90 mmHg or treated hypertension on medication: 1 point
• Age ≥75 years: 2 points
• Diabetes mellitus: 1 point
• Stroke, VTE, TIA: 2 points
• Vascular disease; PAD, MI, aortic plaque: 1 point
• Age 65–74: 1 point
• Sex category, female: 1 point

The CHA₂DS₂-VASc score translates to stroke risk as follows…

0: 0%
1: 1.3%
2: 2.2%
3: 3.2%
4: 4%
5: 6.7%
6 and 7: 9.8%
8: 12.5%
9: 15.2%

Stroke rates vary by study setting, population, and demographic and therapeutic efficacy varies by clinical trial design, but In general, a stroke risk of 2% or over dictates anticoagulant therapy according to international guidelines.

Nielsen PB, Larsen TB, Skjøth F, Overvad TF, Lip GYH. Stroke and thromboembolic event rates in atrial fibrillation according to different guideline treatment thresholds: A nationwide cohort study. Scientific Reports 2016;6: 27410. Bibcode:2016NatSR…627410N. doi:10.1038/srep27410. PMC 4893655. PMID 27265586