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CHADS₂ Score for Atrial Fibrillation Stroke Risk

Estimates stroke risk in patients with atrial fibrillation.

Advice

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

Critical Actions

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.
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