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CHA₂DS₂-VASc score for stroke risk stratification in patients with non-valvular atrial fibrillation, guiding anticoagulation decisions (score 0–9).
Congestive heart failure (1) + Hypertension (1) + Age 65–74 (1) or ≥75 (2) + Diabetes (1) + Stroke/TIA/thromboembolism (2) + Vascular disease (1) + Sex category female (1) = total 0–9
0–9 points
CHA₂DS₂-VASc estimates annual ischemic stroke risk in non-valvular AF. Per 2019 AHA/ACC/HRS and 2020 ESC guidelines, oral anticoagulation is recommended for men with score ≥2 and women with score ≥3. Men with score 1 and women with score 2 may be considered for anticoagulation based on net clinical benefit.
Specialty
CardiologyCategory
CardiologyDifficulty
Basic
Estimated Time
30 seconds
Version
1.0
Last Updated
2026-08-15
Formula
Keywords
Normal Range
0–9 points
Estimates annual ischemic stroke risk in patients with non-valvular atrial fibrillation to guide oral anticoagulation decisions.
Score 0 (men) / 1 (women): low annual stroke risk (~0.2–0.6%) — no antithrombotic therapy recommended. Men score 1 / women score 2: consider OAC based on net clinical benefit. Men ≥2 / women ≥3: oral anticoagulation is recommended.
CHA₂DS₂-VASc refined the older CHADS₂ score by better differentiating truly low-risk patients, reducing unnecessary anticoagulation while capturing more risk factors.
A 78-year-old woman with paroxysmal atrial fibrillation, hypertension, and diabetes who had a TIA 2 years ago.
Inputs:
CHA₂DS₂-VASc score 7 — HIGH stroke risk. Oral anticoagulation is recommended (e.g., DOAC).
Score 0 (men) or 1 (women): low stroke risk, no antithrombotic therapy. Men 1 or women 2: consider oral anticoagulation. Men 2 or more / women 3 or more: oral anticoagulation is recommended.
Women receive 1 point for sex alone, which is a risk modifier rather than an independent risk factor. The threshold for recommending anticoagulation is 1 point higher in women to avoid over-treatment based on sex alone.
No. CHA2DS2-VASc estimates stroke risk only. Bleeding risk should be assessed separately using HAS-BLED or a similar tool before starting anticoagulation.
Disclaimer: This calculator is intended for educational and clinical decision support purposes only. Anticoagulation decisions require assessment of both stroke and bleeding risk together with patient values and preferences.