Atrial Fibrillation CHA(2)DS(2)-VASc Score for Stroke Risk

Clinical Features

Congestive heart failure / LV dysfunction (1 point)

Hypertension (1 point)

Diabetes Mellitus (1 point)

History of stroke, TIA or thromboembolism (2 points)

Vascular disese (history of MI, PVD or aortic atherosclerosis) (1 point)

65-74 years old (1 point)

≥75 years old (2 points)

Female (1 point)

Male (0 points)

Total Criteria Point Count:


Adjusted Stroke Rate

0 points: 0% per year
1 point: 1.3% per year
2 points: 2.2% per year
3 points: 3.2% per year
4 points: 4% per year
5 points: 6.7% per year
6 points: 9.8% per year
7 points: 9.6% per year
8 points: 6.7% per year
9 points: 15.2% per year

  • The Lip-Halperin article seeks to improve stroke risk stratification of the CHADS(2) score by adding more points for age >=75 and Vascular disease.
  • The article suggests aspirin or no treatment for a score of 0, and oral anticoagulation when the score is 2 or greater.
  • The adjusted stroke risk figures are found in the AHA/ACC/HRS Guideline listed below.

  1. Cairns JA. ACP journal club. CHA2DS2-VASc had better discrimination than CHADS2 for predicting risk for thromboembolism in atrial fibrillation. Ann Intern Med. 2011 May 17;154(10):JC5-13. doi: 10.1059/0003-4819-154-10-201105170-02013. PubMed ID: 21576531 PubMed Logo
  2. Olesen JB, Lip GY, Hansen ML, et al. Validation of risk stratification schemes for predicting stroke and thromboembolism in patients with atrial fibrillation: nationwide cohort study. BMJ. 2011 Jan 31;342:d124. doi: 10.1136/bmj.d124. PubMed ID: 21282258 PubMed Logo
  3. January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014 Mar 28. pii: S0735-1097(14)01740-9. PubMed ID: 24685669 PubMed Logo
  4. Lip GY, Halperin JL. Improving stroke risk stratification in atrial fibrillation. Am J Med. 2010 Jun;123(6):484-8. Review. PubMed ID: 20569748 PubMed Logo
  5. Gage BF, Andrade A. ACP Journal Club. Various risk stratification schemes predict ischemic stroke and bleeding in atrial fibrillation. Ann Intern Med. 2012 Oct 16;157(8):JC4-13. doi: 10.7326/0003-4819-157-8-201210160-02013. PubMed ID: 23070515 PubMed Logo
  6. Friberg L, Rosenqvist M, Lip GY. Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182 678 patients with atrial fibrillation: the Swedish Atrial Fibrillation cohort study. Eur Heart J. 2012 Jun;33(12):1500-10. doi: 10.1093/eurheartj/ehr488. Epub 2012 Jan 13. PubMed ID: 22246443 PubMed Logo



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