CHA₂DS₂-VASc
Stroke risk in non-valvular atrial fibrillation, and the trigger for anticoagulation.
When to use it. Deciding whether someone with non-valvular AF should be on an oral anticoagulant.
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Limits of this score. Does not apply to moderate-to-severe mitral stenosis or a mechanical valve — those need anticoagulation regardless of any score. The score estimates stroke risk only; weigh it against bleeding risk, but a high bleeding score is a reason to fix modifiable bleeding risks, not to withhold anticoagulation.
Sources
- Lip GY, 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.
- 2024 ESC Guidelines for the management of atrial fibrillation.
Where this is written from. This site is written from Indian clinical practice. Drug availability and brand names, vaccination schedules, national health programmes and some reference cut-offs differ between countries — a schedule or a threshold that is standard here may not be standard where you are. If you are reading outside India, check anything on this page against your own country’s guidance before you act on it.
Educational use only — not medical advice. Never a substitute for clinical judgement.