CardiologyCardiovascularClinical Decision RuleOpen Access / Terms Apply

CHA₂DS₂-VASc

CHA₂DS₂-VASc Score for Atrial Fibrillation Stroke Risk

Guides clinical decision-making on oral anticoagulation therapy according to ESC and ACC/AHA guidelines.

8 items·Estimated time: ~2 min·Evidence references below

Clinical Formula Calculator

CHA₂DS₂-VASc Parameters

Select All Clinical Criteria That Apply

Congestive Heart Failure / Left Ventricular Dysfunction (+1)

Clinical heart failure or objective LVEF ≤ 40%

Hypertension (+1)

Resting BP > 140/90 mmHg on at least two occasions or current antihypertensive medication

Age ≥ 75 years (+2)

Select this if the patient is 75 or older (trumps age 65–74)

Diabetes Mellitus (+1)

Fasting glucose > 126 mg/dL, HbA1c ≥ 6.5%, or on oral hypoglycemic / insulin therapy

Prior Stroke, TIA, or Thromboembolism (+2)

History of stroke, transient ischemic attack, or systemic embolism

Vascular Disease (+1)

Prior myocardial infarction, peripheral arterial disease, or complex aortic plaque

Age 65–74 years (+1)

Select if patient is between 65 and 74 years old

Sex Category: Female (+1)

Female sex is a risk modifier; score 1 solely for female sex is considered low risk

About the CHA₂DS₂-VASc

Validated clinical risk score predicting annual thromboembolic stroke risk in non-valvular atrial fibrillation.

Scoring Methodology & Interpretation

The CHA₂DS₂-VASc uses a validated custom criteria algorithm with predefined clinical cutoffs established in peer-reviewed derivation and validation cohorts:

Score Range	Severity Classification	Clinical Interpretation
0 – 1	Low Thromboembolic Risk	Score 0 in men, 1 in women. Annual adjusted stroke risk < 1%.
1 – 2	Intermediate Thromboembolic Risk	Score 1 in men, 2 in women. Annual stroke risk ~1.3% – 2.2%.
2 – 9	High Thromboembolic Risk	Score ≥ 2 in men, ≥ 3 in women. Oral anticoagulation strongly recommended.

Clinical Pearls & Considerations

DOACs (apixaban, rivaroxaban, dabigatran, edoxaban) are first-line over warfarin in non-valvular AF.

Developed by Gregory Y.H. Lip and colleagues (2010). Free clinical guideline algorithm.

License: Open Access / Clinical Guideline Tool

Clinical Disclaimer & Scope of Use

This instrument is designed for educational, informational, and clinical reference purposes. Screening scores do not constitute a definitive medical diagnosis. Individual clinical management must integrate full diagnostic history, physical examination, and laboratory data by a licensed healthcare professional.

Applies only to non-valvular AF. Mitral stenosis (moderate-severe) or mechanical heart valves require anticoagulation regardless of score.
Does not replace clinical assessment of bleeding risk or patient preference.

Read our full Medical Disclaimer and Privacy Policy.

Evidence & Primary Literature Citations

Key Validation Study
Refining clinical risk stratification in atrial fibrillation: the CHA2DS2-VASc score.
Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Chest. 2010;137:263-272.
PMID: 19762550 DOI
2020 ESC Guidelines for the diagnosis and management of atrial fibrillation.
Hindricks G, Potpara T, Dagres N, et al. Eur Heart J. 2021;42:373-498.
PMID: 32860505 DOI

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