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Calculate stroke risk in atrial fibrillation using CHADS₂ and CHA₂DS₂-VASc scores
CHADS₂ Score
0
Risk: /year
CHA₂DS₂-VASc
0
Risk: /year
Atrial fibrillation (AFib) increases stroke risk 5-fold. The irregular heartbeat allows blood to pool in the heart's upper chambers, potentially forming clots that can travel to the brain and cause stroke. Risk stratification helps determine who benefits most from anticoagulation therapy.
The CHA₂DS₂-VASc score is now preferred over CHADS₂ as it better identifies truly low-risk patients who may not need anticoagulation, while CHADS₂ tends to underestimate risk in many patients.
No antithrombotic therapy or aspirin. These patients have truly low risk.
Consider oral anticoagulation. Discuss risks and benefits with patient.
Oral anticoagulation recommended unless contraindicated. DOACs preferred over warfarin.
CHA₂DS₂-VASc is now preferred as it better identifies low-risk patients. CHADS₂ may underestimate risk in many patients, particularly women and those with vascular disease.
Bleeding risk should also be assessed using tools like HAS-BLED. However, many bleeding risk factors are modifiable, and stroke risk often outweighs bleeding risk.
These scores are specifically validated for patients with non-valvular atrial fibrillation. Different risk assessments apply for other conditions.