The CHADS2-VASc Score Calculator is a tool used to estimate the risk of stroke in patients with non-valvular atrial fibrillation (AF). This score helps clinicians decide on the appropriate antithrombotic therapy.
Understanding the CHADS2-VASc Score
The CHADS2-VASc score is a clinical prediction rule for estimating the risk of stroke in patients with non-valvular atrial fibrillation (AF), a common heart rhythm disorder. A higher score indicates a greater risk of stroke and typically suggests a need for anticoagulant therapy. It is an extension of the older CHADS2 score, incorporating additional stroke risk factors.
Components of the Score:
| Condition / Risk Factor | Points |
|---|---|
| Congestive heart failure / Left ventricular systolic dysfunction (e.g., LVEF ≤ 40%) | 1 |
| Hypertension (resting BP ≥ 140/90 mmHg on ≥2 occasions, or treated hypertension) | 1 |
| Age ≥ 75 years | 2 |
| Diabetes mellitus (fasting glucose ≥126 mg/dL, HbA1c ≥6.5%, or treated with medication) | 1 |
| S2 Prior Stroke, TIA, or Thromboembolism | 2 |
| Vascular disease (prior myocardial infarction, peripheral artery disease, or complex aortic plaque) | 1 |
| Age 65–74 years | 1 |
| Sex category (Female) | 1 |
| Maximum Possible Score | 9 |
Score Interpretation and Management Guidelines
The CHADS2-VASc score helps guide decisions on anticoagulation to prevent stroke in patients with non-valvular atrial fibrillation. Recommendations often vary slightly between guidelines (e.g., ESC, AHA/ACC/HRS). The following is a general summary based on typical interpretations (e.g., ESC guidelines):
| CHADS2-VASc Score | General Anticoagulation Recommendation (Non-Valvular AF) |
|---|---|
| 0 (Male) | No antithrombotic therapy should be considered (Class IIa). |
| 1 (Female, if female sex is the only risk factor) | No antithrombotic therapy should be considered (Class IIa). |
| 1 (Male) | Oral Anticoagulation (OAC) should be considered (Class IIa). |
| 2 (Female, includes female sex + 1 other non-sex risk factor) | Oral Anticoagulation (OAC) should be considered (Class IIa). |
| ≥2 (Male) | Oral Anticoagulation (OAC) is recommended (Class I). |
| ≥3 (Female) | Oral Anticoagulation (OAC) is recommended (Class I). |
Class I: Benefit >>> Risk. OAC is recommended/indicated.
Class IIa: Benefit >> Risk. OAC should be considered.
This table provides a general summary. Always consult current, complete clinical guidelines and consider individual patient risk factors (including bleeding risk, e.g. HAS-BLED score) and preferences.