maratoolCHA2DS2-VASc Score Calculator
CHA2DS2-VASc score for stroke risk in non-valvular atrial fibrillation (0–9).
References
- Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation. Chest. 2010;137(2):263-272.
What is CHA2DS2-VASc Score?
The CHA2DS2-VASc score is a clinical prediction rule that estimates annual stroke risk in patients with non-valvular atrial fibrillation. Introduced by Lip et al. in 2010 as a refinement of the older CHADS2 score, it assigns points across seven risk factors: congestive heart failure (1), hypertension (1), age 65–74 (1) or ≥75 (2), diabetes (1), prior stroke or thromboembolism (2), vascular disease (1), and female sex (1). The total ranges from 0 to 9. Current guidelines recommend oral anticoagulation when the score is ≥2 in men or ≥3 in women, balanced against bleeding risk.
How to use
- Check each risk factor that applies.
- The score (0–9) and annual stroke risk update instantly.
- Combine with HAS-BLED to guide anticoagulation decisions.
Frequently asked questions
Why is CHA2DS2-VASc preferred over CHADS2?
CHA2DS2-VASc is more sensitive at identifying truly low-risk patients (score 0) who do not benefit from anticoagulation, and incorporates additional risk factors (sex, vascular disease, broader age strata).
When should anticoagulation be started?
Guidelines (2024 ACC/AHA) recommend anticoagulation when CHA2DS2-VASc ≥ 2 in men or ≥ 3 in women. Consider for score ≥ 1 in men / ≥ 2 in women.
Does sex category alone justify anticoagulation?
No — female sex alone (score = 1 for a woman with no other risk factors) does not require anticoagulation per current guidelines.
How does CHA2DS2-VASc interact with HAS-BLED?
Use CHA2DS2-VASc to assess stroke risk; use HAS-BLED to identify modifiable bleeding risks. A high HAS-BLED is not a contraindication — it flags risks to address.
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