CHADS₂ Score for Atrial Fibrillation Stroke Risk

• Consider applying the CHA₂DS₂-VASc Score to patients with a CHADS₂ score of 0 in order to further risk stratify these patients.

One recommendation suggests a 0 score is low risk and may not require anticoagulation, however there is literature that suggests that not all patients with a CHADS₂ score of 0 are at low risk for ischemic stroke.

• Consider using the CHA₂DS₂-VASc Score to further risk stratify patients who are identified as low risk by their CHADS₂ score.
• For patients who are identified as moderate (score 1-2) or high risk for ischemic stroke (>3), anticoagulation therapy should be considered.
• For those patients in whom anticoagulation is considered, bleeding risk scores such as ATRIA, HAS-BLED or HEMORR₂HAGES can be used to determine the risk for warfarin-associated hemorrhage.
• Carefully consider all the risks and benefits prior to initiating anticoagulation in patients with non-valvular AF.