Stroke Risk Evaluation Timeline

Find out how the CHA2DS2-VASc score is used to determine stroke risk in patients with atrial fibrillation

CHA2DS2-VASc
CHA2DS2-VASc
C
Heart Failure
Congestive heart failure (or left ventricular systolic dysfunction)
H
Hypertension
A2
Age
D
Diabetes Mellitus
S2
Stroke
V
Vascular Disease
A
Age
Sc
Sex Category (Female)
Clinical decision point

CHA2DS2-VASc CHA2DS2-VASc

The CHA2DS2-VASc score can help determine the 1-year risk of a thromboembolic event in a non-anticoagulated patient with AF. A higher score indicates a greater risk of stroke1

C C

Signs/symptoms of heart failure or objective evidence of reduced left-ventricular ejection fraction2

= 1 point

H H

Blood pressure consistently above 140/90 mmHg or currently receiving medication for hypertension2

= 1 point

A2 A2

Patient is aged ≥75 years2

= 2 points

D D

Fasting glucose >125 mg/dl (7 mmol/l) or treatment with oral hypoglycaemic agent and/or insulin2

= 1 point

S2 S2

Prior stroke, TIA or thromboembolism

= 2 points

V V

Including PAD, MI and aortic plaque

= 1 point

A A

Patient is aged 65–74 years

= 1 point

Sc Sc

Female gender confers an increased risk of stroke

= 1 point

Clinical decision point

‘Patients without clinical stroke risk factors do not need antithrombotic therapy, whereas patients with stroke risk factors (i.e. CHA2DS2-VASc score ≥1 for men, and ≥2 for women) are likely to benefit from OAC treatment’ – ESC guidelines 2016. For patients eligible for OAC therapy, a NOAC is recommended in preference to a VKA2

Show references

Approval Code: PP-XAR-ALL-0562-1

  1. Lip GYH, Nieuwlaat R, Pisters R et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor based approach: The Euro Heart Survey on Atrial Fibrillation. Chest 2010;137:263–272.
  1. Kirchhof P, Benussi S, Kotecha D et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016;37:2893-2962.