CHADS2 Scoring Scheme
Condition | Points | |
C | Congestive heart failure | 1 |
H | Hypertension | 1 |
A | Age > 75 years | 1 |
D | Diabetes Mellitus | 1 |
S2 | Prior Stroke or TIA | 2 |
Annual Stroke Risk with Respect to CHADS 2 Score (1)
CHADS2 Score | Stroke Risk % | 95% confidence interval |
0 | 1.9 | 1.2-3.0 |
1 | 2.8 | 2.0-3.8 |
2 | 4.0 | 3.1-5.1 |
3 | 5.9 | 4.6-7.3 |
4 | 8.5 | 6.3-11.1 |
5 | 12.5 | 8.2-17.5 |
6 | 18.2 | 10.5-27.4 |
Anticoagulation based on the CHADS2 score
Score | Risk | Anticoagulation Therapy | Considerations |
0 | Low | Aspirin or no treatment | No antithrombotic therapy (or aspirin) |
1 | Moderate | Aspirin or Warfarin | Aspirin daily or raise INR to 2.0-3.0, depending on factors such as patient preference |
2 or greater | Moderate or High | Warfarin | Raise INR to 2.0-3.0, unless contraindicated (e.g. clinically significant GI bleeding, inability to obtain regular INR screening) |
To complement the CHADS2 score, by the inclusion of additional 'stroke risk modifier' risk factors, the CHA2DS2-VASc score was developed (2)
CHA2DS2-VASc score for stroke risk in atrial fibrillation
Feature | Score |
Congestive Heart Failure | 1 |
Hypertension | 1 |
Age >75 years | 2 |
Age between 65 and 74 years | 1 |
Stroke/TIA/TE | 2 |
Vascular disease (previous MI, peripheral arterial disease or aortic plaque) | 1 |
Diabetes mellitus | 1 |
Female | 1 |
NICE suggest (3):
Reference:
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