The CHA2DS2-VASc Score is used to estimate the risk of stroke in patients with atrial fibrillation.

The CHA2DS2-VASc Score is based on seven factors, each assigned a specific number of points:

• Age ≥75 years: 2 points
• Age 65-74 years: 1 point
• Age <65 years: 0 points
• Sex (Female): 1 point
• Congestive Heart Failure: 1 point
• Hypertension: 1 point
• Stroke/TIA/Thromboembolism: 2 points
• Vascular Disease: 1 point
• Diabetes Mellitus: 1 point

Higher combined scores are predictive of a greater risk of stroke.

According to the CHA2DS2-VASc score:

Interpretation:

CHA₂DS₂-VASc Score	Risk of ischemic stroke	Risk of stroke/TIA/systemic embolism
0	0.2%	0.3%
1	0.6%	0.9%
2	2.2%	2.9%
3	3.2%	4.6%
4	4.8%	6.7%
5	7.2%	10.0%
6	9.7%	13.6%
7	11.2%	15.7%
8	10.8%	15.2%
9	12.2%	17.4%

0 points:

Stroke risk was 0.2% per year in >90,000 patients (the Swedish Atrial Fibrillation Cohort Study) and 0.3% risk of stroke/TIA/systemic embolism.

One recommendation suggests a 0 score for men or 1 score for women (no clinical risk factors) is “low” risk and may not require anticoagulation; a 1 score for men or 2 score for women is “low-moderate” risk and should consider anticoagulation; and a score ≥2 for men or ≥3 for women is “moderate-high” risk and should otherwise be an anticoagulation candidate.

1 point:

Stroke risk was 0.6% per year in >90,000 patients (the Swedish Atrial Fibrillation Cohort Study) and 0.9% risk of stroke/TIA/systemic embolism.

One recommendation suggests a 0 score for men or 1 score for women (no clinical risk factors) is “low” risk and may not require anticoagulation; a 1 score for men or 2 score for women is “low-moderate” risk and should consider anticoagulation; and a score ≥2 for men or ≥3 for women is “moderate-high” risk and should otherwise be an anticoagulation candidate.

2 points:

Stroke risk was 2.2% per year in >90,000 patients (the Swedish Atrial Fibrillation Cohort Study) and 2.9% risk of stroke/TIA/systemic embolism.

One recommendation suggests a 0 score for men or 1 score for women (no clinical risk factors) is “low” risk and may not require anticoagulation; a 1 score for men or 2 score for women is “low-moderate” risk and should consider anticoagulation; and a score ≥2 for men or ≥3 for women is “moderate-high” risk and should otherwise be an anticoagulation candidate.

3 points:

Stroke risk was 3.2% per year in >90,000 patients (the Swedish Atrial Fibrillation Cohort Study) and 4.6% risk of stroke/TIA/systemic embolism.

One recommendation suggests a 0 score for men or 1 score for women (no clinical risk factors) is “low” risk and may not require anticoagulation; a 1 score for men or 2 score for women is “low-moderate” risk and should consider anticoagulation; and a score ≥2 for men or ≥3 for women is “moderate-high” risk and should otherwise be an anticoagulation candidate.

4 points:

Stroke risk was 4.8% per year in >90,000 patients (the Swedish Atrial Fibrillation Cohort Study) and 6.7% risk of stroke/TIA/systemic embolism.

One recommendation suggests a 0 score for men or 1 score for women (no clinical risk factors) is “low” risk and may not require anticoagulation; a 1 score for men or 2 score for women is “low-moderate” risk and should consider anticoagulation; and a score ≥2 for men or ≥3 for women is “moderate-high” risk and should otherwise be an anticoagulation candidate.

5 points:

Stroke risk was 7.2% per year in >90,000 patients (the Swedish Atrial Fibrillation Cohort Study) and 10.0% risk of stroke/TIA/systemic embolism.

One recommendation suggests a 0 score for men or 1 score for women (no clinical risk factors) is “low” risk and may not require anticoagulation; a 1 score for men or 2 score for women is “low-moderate” risk and should consider anticoagulation; and a score ≥2 for men or ≥3 for women is “moderate-high” risk and should otherwise be an anticoagulation candidate.

6 points:

Stroke risk was 9.7% per year in >90,000 patients (the Swedish Atrial Fibrillation Cohort Study) and 13.6% risk of stroke/TIA/systemic embolism.

One recommendation suggests a 0 score for men or 1 score for women (no clinical risk factors) is “low” risk and may not require anticoagulation; a 1 score for men or 2 score for women is “low-moderate” risk and should consider anticoagulation; and a score ≥2 for men or ≥3 for women is “moderate-high” risk and should otherwise be an anticoagulation candidate.

7 points:

Stroke risk was 11.2% per year in >90,000 patients (the Swedish Atrial Fibrillation Cohort Study) and 15.7% risk of stroke/TIA/systemic embolism.

One recommendation suggests a 0 score for men or 1 score for women (no clinical risk factors) is “low” risk and may not require anticoagulation; a 1 score for men or 2 score for women is “low-moderate” risk and should consider anticoagulation; and a score ≥2 for men or ≥3 for women is “moderate-high” risk and should otherwise be an anticoagulation candidate.

8 points:

Stroke risk was 10.8% per year in >90,000 patients (the Swedish Atrial Fibrillation Cohort Study) and 15.2% risk of stroke/TIA/systemic embolism.

We realize that 8 points showed a lower risk than 7 points, these were the findings in the study, obviously one should assume all scores ≥7 have a risk >10%.

One recommendation suggests a 0 score for men or 1 score for women (no clinical risk factors) is “low” risk and may not require anticoagulation; a 1 score for men or 2 score for women is “low-moderate” risk and should consider anticoagulation; and a score ≥2 for men or ≥3 for women is “moderate-high” risk and should otherwise be an anticoagulation candidate.

9 points:

Stroke risk was 12.2% per year in >90,000 patients (the Swedish Atrial Fibrillation Cohort Study) and 17.4% risk of stroke/TIA/systemic embolism.

One recommendation suggests a 0 score for men or 1 score for women (no clinical risk factors) is “low” risk and may not require anticoagulation; a 1 score for men or 2 score for women is “low-moderate” risk and should consider anticoagulation; and a score ≥2 for men or ≥3 for women is “moderate-high” risk and should otherwise be an anticoagulation candidate.

The CHA2DS2-VASc Score was proposed by Dr. Gregory Y.H. Lip and colleagues. It has been validated in multiple studies and is widely used to predict stroke risk in patients with atrial fibrillation.