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CHA₂DS₂-VASc Score (AFib Stroke Risk)

Written by the Elysia Tools team · Last updated：2026-08-06

This tool is for informational purposes only and does not constitute medical, financial, or legal advice; consult a qualified professional for advice.

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.

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Tool usage guide

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Key facts

Category
Health
Input types
select, checkbox
Output type
json
Sample coverage
4
API ready
Yes

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.

When to use

  • Estimate stroke risk for a patient with non-valvular atrial fibrillation.

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  • 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

    1. 1Select the patient's age group and biological sex.
    2. 2Mark each applicable condition: heart failure or left ventricular dysfunction, hypertension, diabetes, prior stroke/TIA/thromboembolism, and vascular disease.
    3. 3The calculator adds the corresponding points, including 2 points for age 75 or older and 2 points for prior stroke, TIA, or thromboembolism.
    4. 4It 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.

    Examples

    1. Older woman with hypertension and prior TIA

    Cardiology clinician

    Background

    A 75-year-old woman with non-valvular atrial fibrillation has hypertension and a prior transient ischemic attack.

    Problem

    Calculate her CHA₂DS₂-VASc score and identify the anticoagulation discussion category.

    How to use

    Select age ≥75 years and female, then mark hypertension and prior stroke/TIA/thromboembolism.

    {"ageGroup":"gte75","sex":"female","chf":false,"hypertension":true,"diabetes":false,"stroke":true,"vascular":false}

    Outcome

    The score is 6. The tool recommends oral anticoagulation, preferably a DOAC over warfarin, and reports an approximate annual stroke risk of 13.6%.

    2. Man aged 65–74 with no additional risk factors

    Primary care clinician

    Background

    A 65-year-old man with non-valvular atrial fibrillation has no recorded heart failure, hypertension, diabetes, prior stroke or TIA, thromboembolism, or vascular disease.

    Problem

    Determine whether anticoagulation should be considered based on the score.

    How to use

    Select age 65–74 years and male, leaving all condition checkboxes unselected.

    {"ageGroup":"65to74","sex":"male","chf":false,"hypertension":false,"diabetes":false,"stroke":false,"vascular":false}

    Outcome

    The score is 1. The tool indicates that oral anticoagulation may be considered using shared decision-making and reports an approximate annual stroke risk of 0.6%.

    FAQ

    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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