CHA₂DS₂-VASc Score
Estimate stroke risk in atrial fibrillation patients.
Last updated on: August 25, 2025
Input Patient Data
What is the CHA₂DS₂-VASc Score?
The CHA₂DS₂-VASc score is a clinical tool used to estimate the risk of stroke in patients with atrial fibrillation.
It extends the CHADS₂ score by including additional risk factors such as vascular disease, female sex, and age 65–74.
Why is it useful?
The score helps clinicians decide on the need for anticoagulation therapy.
It is recommended by both ESC and AHA/ACC/HRS guidelines for stroke prevention in AF patients.
Risk Stratification
Low Risk:
Score = 0 in men or 1 in women. Stroke risk <1% annually. Anticoagulation is not recommended.
Intermediate Risk:
Score = 1 in men or 2 in women. Stroke risk 1–2% annually. Consider anticoagulation depending on comorbidities and preferences.
High Risk:
Score ≥2 in men or ≥3 in women. Stroke risk ≥3–5% annually. Oral anticoagulation is strongly recommended.
Scientific References
- Lip GYH et al. Stroke and bleeding risk assessment in AF: European Heart Journal, 2010.
- January CT et al. 2019 AHA/ACC/HRS Atrial Fibrillation Guideline.
- Hindricks G et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation.
Guideline Highlights
- ESC 2020: Anticoagulation recommended for men with score ≥2 and women with score ≥3.
- ACC/AHA/HRS 2019: Consider NOACs or warfarin unless contraindicated.
This page has been medically reviewed by Dr. Khoulah Attia – PharmD, Immunology Specialist.