CHA2DS2-VASc Stroke Risk Score

CHA2DS2-VASc (Lip 2010); thresholds per ESC 2020 AF guideline

Adds points for heart failure, hypertension, age bands, diabetes, prior stroke/TIA, vascular disease, and female sex to estimate the annual stroke risk in atrial fibrillation and guide oral anticoagulation.

Also searched as: atrial fibrillation · anticoagulation · cardioembolic · af

Lower concern

CHA2DS2-VASc 0 — ~0%/year stroke risk

Score: 0

Total score: 0 of 9.
Estimated adjusted annual stroke/thromboembolism rate: ~0% per year (Lip 2010 cohort).
No risk factors present.
No antithrombotic therapy indicated on stroke-risk grounds (ESC: score 0 men / 1 women).
Assess bleeding risk in parallel with HAS-BLED; a high HAS-BLED score flags modifiable factors but does not by itself preclude anticoagulation.

Caveats

Cohort-derived risk percentages are approximate; use the score primarily as a treatment threshold.
Not validated for valvular AF (moderate-severe mitral stenosis or mechanical valve).

How this tool works

CHA2DS2-VASc assigns 1 point each for heart failure, hypertension, diabetes, vascular disease, age 65-74, and female sex, and 2 points each for age 75 or more and prior stroke/TIA/thromboembolism, for a maximum of 9. ESC guidance: anticoagulation is recommended at a score of 2 or more in men (3 or more in women), should be considered at 1 in men (2 in women), and is not indicated at 0 in men (1 in women) — female sex functions as a risk modifier rather than a stand-alone indication. The displayed annual risk percentages are the adjusted event rates from the derivation cohort (Lip 2010).

References

Implemented from the cited published sources. Educational use only; confirm against current guidelines before clinical use.

Related calculators

Same subspecialty, overlapping subject matter.

HAS-BLED Bleeding Risk Score