CHA₂DS₂-VASc Stroke Risk Calculator

What Is CHA₂DS₂-VASc? The CHA₂DS₂-VASc score is a clinical scoring system used to estimate the risk of stroke in patients with non-valvular atrial fibrillation (AFib). AFib is the most common heart rhythm disorder, affecting over 33 million people worldwide. Without treatment, AFib increases stroke risk by 5-fold compared to the general population. The score was developed in 2010 by Lip and colleagues and is now the international standard, used in ESC, ACC/AHA, and most national guidelines.

Score Components C, Congestive heart failure (1 point): recent decompensated heart failure or reduced ejection fraction. H, Hypertension (1 point): persistent BP above 140/90 mmHg or on antihypertensive medication. A₂, Age ≥ 75 years (2 points): higher weighting due to exponentially higher stroke risk. D, Diabetes mellitus (1 point): type 1 or type 2 diabetes on medication. S₂, Prior Stroke / TIA / Thromboembolism (2 points): the strongest independent risk factor. V, Vascular disease (1 point): prior MI, peripheral artery disease, or aortic plaque. A, Age 65–74 years (1 point): note that age 75+ scores differently (A₂ = 2 points). Sc, Sex category female (1 point): biological females have higher baseline stroke risk in AFib.

Annual Stroke Risk by Score Score 0 (male) or 1 (female alone): low risk, approximately 0% per year. No anticoagulation needed. Score 1 (male): approximately 1.3% per year. Guidelines suggest anticoagulation consideration. Score 2: approximately 2.2% per year. Oral anticoagulation is recommended. Score 3: approximately 3.2% per year. Strong recommendation for anticoagulation. Score 4: approximately 4.0% per year. High risk, anticoagulation essential. Score 5: approximately 6.7% per year. Score 6: approximately 9.8% per year. Score 7+: very high risk, 9–15%+ per year. Aggressive anticoagulation management required.

Treatment Guidelines Score 0 (men) or 1 (women only): no anticoagulation. Score ≥ 1 (men) or ≥ 2 (women): oral anticoagulation with a DOAC (apixaban, rivaroxaban, dabigatran, edoxaban). Warfarin remains an option but requires more monitoring (INR target 2.0–3.0). This calculator is for educational purposes. Treatment decisions must be made by a qualified physician.

Important Disclaimer This calculator provides a general estimate for educational purposes only. It is NOT a substitute for clinical evaluation by a licensed healthcare professional.