CHA₂DS₂-VASc Score for Atrial Fibrillation Stroke Risk
Should this patient with atrial fibrillation receive oral anticoagulation for stroke prevention?
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About this tool
Stroke and thromboembolism risk score for non-valvular atrial fibrillation; also displays the sex-neutral CHA₂DS₂-VA value.
Intended use
Adults with non-valvular atrial fibrillation or flutter.
Outcome
Stroke / thromboembolism
Time horizon
Annual risk
Derivation population
Euro Heart Survey on AF (derivation); validated in large national registries.
Do not use in
Moderate–severe mitral stenosis, mechanical heart valves.
Limitations
- Modest discrimination (C-statistic typically ~0.6–0.7).
- Treats each risk factor as binary and does not include biomarkers or AF burden.
Clinical problems
Evidence
Evidence level
Strong evidence
Derived and externally validated in multiple cohorts (including prospective studies) and incorporated into major clinical guidelines. Methodology
Guideline status
Recommended in the 2023 ACC/AHA/ACCP/HRS AF guideline; the 2024 ESC AF guideline uses CHA₂DS₂-VA.
Discrimination
Modest (C-statistic ~0.6–0.7 across cohorts).
References
- Original publicationLip GYH, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach. Chest 2010;137:263-272. Find on PubMed (opens in a new tab)
- GuidelineJoglar JA, Chung MK, et al. 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation. Circulation 2024;149:e1-e156. Find on PubMed (opens in a new tab)
- GuidelineVan Gelder IC, Rienstra M, et al. 2024 ESC Guidelines for the management of atrial fibrillation. Eur Heart J 2024;45:3314-3414. Find on PubMed (opens in a new tab)
Version history
| Version | Formula | Effective | Reviewer | Changes |
|---|---|---|---|---|
| v1.0.0 | Lip 2010 point allocation | 2026-10-03 | — | Initial implementation with reference test vectors. |
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Clinical decision support only. Interpret results in the context of the individual patient and current guidance; HumanPulse does not replace professional medical judgment.