Calculator · Cardiovascular

CHA₂DS₂-VASc

Stroke risk score in non-valvular AF.

What it is for

AF review. NICE NG196 uses CHA₂DS₂-VASc for stroke risk — read the anticoagulation recommendations in the guideline itself.

Use the working calculator

The working CHA₂DS₂-VASc calculator is on our calculators page. It is free and needs no account. Enter the values and it shows the result with the reading that goes with it.

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What you enter

The calculator asks for 8 items.

  • Congestive heart failure / LV dysfunction (1 point)
  • Hypertension (history or treated) (1 point)
  • Age ≥ 75 (2 points)Adds 2 — significant risk factor.
  • Diabetes mellitus (1 point)
  • Previous stroke / TIA / thromboembolism (2 points)Adds 2.
  • Vascular disease (MI / PVD / aortic plaque) (1 point)
  • Age 65–74 (1 point)Ticking this unticks age ≥ 75 (only one age band applies)
  • Female sex (1 point)Always scores 1. NICE NG196: a score of 1 from sex alone is not a reason to anticoagulate.

How the result is read

The result is shown as CHA₂DS₂-VASc score, out of a maximum of 9.

The calculator reads each total as follows. Where a single answer changes the reading (for example sex, age or one extreme value), the working calculator says so.

TotalBandWhat the calculator says
0Very low riskNICE NG196 1.6.7: do not offer anticoagulation to people under 65 with no risk factors other than their sex (a score of 0 for men or 1 for women). See the atrial fibrillation protocol and NICE NG196 for the full recommendation. Reassess stroke and bleeding risk at review as risk factors change.
1Low riskNICE NG196 1.6.4: consider anticoagulation for men with a score of 1, taking bleeding risk into account. See the atrial fibrillation protocol and NICE NG196 for the full recommendation. Annual stroke risk ~0.6%.
2Moderate-highNICE NG196 1.6.3: offer anticoagulation to people with a score of 2 or more, taking bleeding risk into account. See the atrial fibrillation protocol and NICE NG196 for the full recommendation. Annual stroke risk ~2%.
3 to 5High riskNICE NG196: offer anticoagulation to people with a score of 2 or more, taking bleeding risk into account. See the atrial fibrillation protocol and NICE NG196 for the full recommendation. Annual stroke risk rises with score (3 → ~3%; 5 → ~7%). NICE NG196 uses ORBIT to assess bleeding risk.
6 to 9Very high riskNICE NG196: offer anticoagulation to people with a score of 2 or more, taking bleeding risk into account. See the atrial fibrillation protocol and NICE NG196 for the full recommendation. Annual stroke risk ≥9%.

Sources

These are the sources the calculator cites. Check the current version before relying on a threshold.

Related

HAS-BLEDMajor bleeding risk on anticoagulation for AF.ORBITAlternative bleeding risk score for AF — may outperform HAS-BLED.QRISK3 (10-year CV risk)Predicts 10-year risk of MI / stroke. Proprietary algorithm. For education and practice only. For patient care, use the QRISK3 tool built into your clinical system (NICE NG238).ABCD₂ (TIA stroke risk)Risk of stroke after TIA within 7 days.QTc (Bazett)Heart-rate-corrected QT interval.All calculators60 clinical scores and tools

For qualified clinicians. A score supports a clinical decision and does not make it: check the inputs, read the cited source, and use the tools in your clinical system for patient care where one is provided.