The CHA₂DS₂-VASc score is a clinical prediction rule used to estimate the risk of stroke in patients with non-rheumatic atrial fibrillation (AF), a common cardiac arrhythmia. This tool is especially valuable in identifying low-risk patients who might not need anticoagulation therapy.
Here’s a brief outline of the components of the CHA₂DS₂-VASc score:
- C: Congestive heart failure (or Left Ventricular Dysfunction) – 1 point
- H: Hypertension (blood pressure consistently above 140/90 mmHg or treated hypertension on medication) – 1 point
- A₂: Age ≥ 75 years – 2 points
- D: Diabetes Mellitus – 1 point
- S₂: Prior Stroke or Transient Ischemic Attack (TIA) or thromboembolism – 2 points
- V: Vascular disease (e.g., peripheral artery disease, myocardial infarction, aortic plaque) – 1 point
- A: Age 65–74 years – 1 point
- Sc: Sex category (i.e., female gender) – 1 point
The total score can range from 0 to 9 points.
The interpretation is generally as follows:
- 0 points: Low risk
- 1 point: Moderate risk
- 2 or more points: High risk
Based on the score, clinicians decide whether to start anticoagulant therapy to reduce the risk of stroke in patients with AF. Patients with higher scores are more likely to benefit from anticoagulation.
Remember, while the CHA₂DS₂-VASc score provides guidance, clinical decisions should always take into account individual patient factors and preferences.