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CHA₂DS₂-VASc score for stroke risk stratification in patients with non-valvular atrial fibrillation, guiding anticoagulation decisions (score 0–9).
Clinical decision-support tool for qualified healthcare professionals. Results are not a diagnosis and should not replace professional clinical judgment.
CHA₂DS₂-VASc estimates annual ischemic stroke risk in non-valvular AF. Per 2019 AHA/ACC/HRS and 2020 ESC guidelines, oral anticoagulation is recommended for men with score ≥2 and women with score ≥3. Men with score 1 and women with score 2 may be considered for anticoagulation based on net clinical benefit.
Specialty
CardiologyCategory
CardiologyDifficulty
Basic
Estimated Time
30 seconds
Version
1.0
Last Updated
2026-08-15
Formula
Keywords
Normal Range
0–9 points
Estimates annual ischemic stroke risk in patients with non-valvular atrial fibrillation to guide oral anticoagulation decisions.
CHA2DS2-VASc adds 1 point each for congestive heart failure/LV dysfunction, hypertension, diabetes, vascular disease, and female sex, 2 points for age 75 or older, 2 points for prior stroke/TIA/systemic thromboembolism, and 1 point for age 65-74, for a total of 0-9. Annual stroke risk rises with the score.
Congestive heart failure or LV dysfunction; Yes adds 1 point.
Treated or untreated hypertension; Yes adds 1 point.
Age band, scored 0 (under 65), 1 (65-74), or 2 (75 or older).
Diabetes; Yes adds 1 point.
Prior stroke, TIA, or systemic thromboembolism; Yes adds 2 points.
Prior MI, peripheral artery disease, or aortic plaque; Yes adds 1 point.
Female sex adds 1 point; male sex adds none.
Score 0 (men) / 1 (women): low annual stroke risk (~0.2–0.6%) — no antithrombotic therapy recommended. Men score 1 / women score 2: consider OAC based on net clinical benefit. Men ≥2 / women ≥3: oral anticoagulation is recommended.
CHA₂DS₂-VASc refined the older CHADS₂ score by better differentiating truly low-risk patients, reducing unnecessary anticoagulation while capturing more risk factors.
A 78-year-old woman with paroxysmal atrial fibrillation, hypertension, and diabetes who had a TIA 2 years ago.
Inputs:
Expected Result: CHA₂DS₂-VASc score 7 — HIGH stroke risk. Oral anticoagulation is recommended (e.g., DOAC).
Score 0 (men) or 1 (women): low stroke risk, no antithrombotic therapy. Men 1 or women 2: consider oral anticoagulation. Men 2 or more / women 3 or more: oral anticoagulation is recommended.
Women receive 1 point for sex alone, which is a risk modifier rather than an independent risk factor. The threshold for recommending anticoagulation is 1 point higher in women to avoid over-treatment based on sex alone.
No. CHA2DS2-VASc estimates stroke risk only. Bleeding risk should be assessed separately using HAS-BLED or a similar tool before starting anticoagulation.
Disclaimer: This calculator is intended for educational and clinical decision support purposes only. Anticoagulation decisions require assessment of both stroke and bleeding risk together with patient values and preferences.