# CHA₂DS₂-VASc Score (AFib Stroke Risk)

Calculate the CHA₂DS₂-VASc score to stratify stroke risk in non-valvular atrial fibrillation and guide oral anticoagulation. Components: Congestive heart failure/LV dysfunction (+1), Hypertension (+1), Age ≥75 (+2), Diabetes (+1), prior Stroke/TIA/thromboembolism (+2), Vascular disease — prior MI/PAD/aortic plaque (+1), Age 65–74 (+1), Sex category female (+1). Range 0–9 (women) / 0–8 (men). Thresholds: men ≥2 or women ≥3 → recommend oral anticoagulation (DOAC preferred over warfarin); men 1 or women 2 → consider anticoagulation; men 0 or women ≤1 → omit. Female sex alone is not an independent risk factor (score 1 from sex alone is treated as 0). Includes an approximate annual stroke-risk estimate (Lip 2010 derivation cohort). Derived from Lip 2010 (Chest), 2019 AHA/ACC/HRS update, and 2023 ACC/AHA/ACCP/HRS AF guideline. Combine with bleeding risk (HAS-BLED) and shared decision-making. Not medical advice.

> Canonical page: https://elysiatools.com/en/tools/chads2-vasc-score

- **Category:** Health

- **Keywords:** CHA2DS2-VASc, CHADS2-VASc, atrial fibrillation, AFib, stroke risk, anticoagulation, DOAC, warfarin, cardiology, oral anticoagulant

## Overview

The CHA₂DS₂-VASc score calculator estimates stroke risk in adults with non-valvular atrial fibrillation using age, sex, heart failure or left ventricular dysfunction, hypertension, diabetes, prior stroke or TIA, thromboembolism, and vascular disease. It provides a score, an approximate annual stroke-risk estimate, and an anticoagulation discussion category. It is not medical advice.

## Inputs

- **Age** (select): Age band. <65 scores 0; 65–74 scores 1; ≥75 scores 2.
- **Sex** (select): Biological sex. Female scores +1 (sex category). Female sex alone does NOT trigger anticoagulation.
- **Congestive heart failure / LV dysfunction** (checkbox): Congestive heart failure or left ventricular dysfunction. +1 if present.
- **Hypertension** (checkbox): Hypertension (treated or untreated). +1 if present.
- **Diabetes mellitus** (checkbox): Diabetes mellitus. +1 if present.
- **Prior stroke / TIA / thromboembolism** (checkbox): Prior ischemic stroke, TIA, or systemic thromboembolism. +2 if present.
- **Vascular disease (prior MI, PAD, aortic plaque)** (checkbox): Prior myocardial infarction, peripheral artery disease, or aortic atherosclerotic plaque. +1 if present.

## When to use

- Estimate stroke risk for a patient with non-valvular atrial fibrillation.
- Review how age and common cardiovascular conditions affect the CHA₂DS₂-VASc score.
- Support an anticoagulation discussion alongside bleeding risk assessment and shared decision-making.

## How it works

- Select the patient's age group and biological sex.
- Mark each applicable condition: heart failure or left ventricular dysfunction, hypertension, diabetes, prior stroke/TIA/thromboembolism, and vascular disease.
- The calculator adds the corresponding points, including 2 points for age 75 or older and 2 points for prior stroke, TIA, or thromboembolism.
- It returns the total score, score components, an approximate annual stroke-risk estimate, and an anticoagulation recommendation category.

## Use cases

- Cardiology consultations for stroke-risk stratification in atrial fibrillation.
- Primary care reviews when evaluating anticoagulation options.
- Clinical education on how age, prior stroke, hypertension, diabetes, and vascular disease contribute to risk.

## Frequently asked questions

### What does the CHA₂DS₂-VASc score measure?

It estimates stroke risk in people with non-valvular atrial fibrillation and helps inform anticoagulation discussions.

### What is the maximum CHA₂DS₂-VASc score?

The range is 0–9 for women and 0–8 for men.

### Does female sex alone require anticoagulation?

No. Female sex alone is treated as a score of 0 for anticoagulation decisions.

### When is oral anticoagulation generally recommended?

The tool identifies men with scores of at least 2 and women with scores of at least 3 as candidates for recommended oral anticoagulation, with a DOAC preferred over warfarin.

### Is this calculator medical advice?

No. Use the result with bleeding-risk assessment, such as HAS-BLED, clinician judgment, and shared decision-making.

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