Table 2. CHA
2
DS
2
-VASc Risk Assessment Score
Risk Factor Score (if present)
C
Congestive heart failure
1
H
Hypertension
1
A
Age ≥75 y
2
D
Diabetes mellitus
1
S
Prior stroke or TIA
2
V
Vascular disease
2
A
Age 65–74 y
1
Sc
Sex category (female)
1
Total Score for a maximum of 10
Table 3. Treatment Based on CHADS
2
Score
CHADS
2
Score
Recommended
Treatment Statement for Shared Decision Making
0 Do not
anticoagulate
• Benefit < Harm
• Patients without additional risk factors for stroke most
likely will benefit less from treatment with a similar risk
for bleeding.
1 Options include
aspirin or
anticoagulation
• Benefit > Harm
• Patients with an additional risk factor for stroke will
benefit from treatment. Aspirin can be considered for
patients at an increased risk of bleeding. Choice of therapy
should be based on patient preferences and bleed risk.
2–6 Recommend
anticoagulation
• Benefit > Harm
• Patients with additional risk factors for stroke will benefit
from treatment. The evidence is currently insufficient to
preferentially recommend one anticoagulant over others.
Choice of anticoagulant should be based on patient
preferences. Dual antiplatelet and anticoagulant therapy
should not be used.
e CHADS
2
score is calculated by adding 1 point each for recent congestive heart failure
(i.e., active within the past 100 days or documented by echocardiography), hypertension
(systolic and/or diastolic), age ≥75 years, and diabetes mellitus, and adding 2 points for a
history of stroke or transient ischemic attack. A score of 0–1 was designated as low risk; a score
of 2–3 was designated as moderate risk; and a score of 4, 5 or 6 was designated as high risk.
Treatment