Question 1

What is the CHA₂DS₂-VASc score used for?

Accepted Answer

It estimates the risk of ischemic stroke in people with nonvalvular atrial fibrillation, and is used alongside a bleeding-risk assessment to help decide whether anticoagulation is likely to provide net benefit.

Question 2

What does each letter stand for?

Accepted Answer

Congestive heart failure, Hypertension, Age ≥75 (2 points), Diabetes, prior Stroke/TIA/thromboembolism (2 points), Vascular disease, Age 65–74, and Sex category female. Each factor present adds its points to the total, up to a maximum of 9.

Question 3

Does being female always add a point that matters?

Accepted Answer

Female sex adds 1 point, but current guidelines generally treat female sex as a risk modifier rather than a standalone risk factor — a score of 1 arising only from being female is typically not, by itself, considered a reason to start anticoagulation the way a score of 1 from another factor might be.

Question 4

What score means anticoagulation is recommended?

Accepted Answer

Guidelines commonly suggest anticoagulation is reasonable at a score of 2 or more in men and 3 or more in women, and that it may be considered at 1 (men) or 2 (women, when the point isn’t from sex alone). These are general guideline positions — the actual decision should weigh bleeding risk and individual patient preference with a clinician.

Question 5

Where do the annual stroke risk percentages come from?

Accepted Answer

They’re from a large Swedish registry cohort (Friberg et al., 2012) and are commonly cited alongside the score. Other cohorts report somewhat different absolute rates, and the source data is non-monotonic at the highest scores (7 and 8 show lower observed rates than 6) because relatively few patients in that cohort had those scores — treat these numbers as illustrative, not a precise personal prediction.

Criterion	Points
Congestive heart failure / LV dysfunction	1
Hypertension	1
Age ≥ 75	2
Diabetes mellitus	1
Stroke, TIA, or thromboembolism (prior)	2
Vascular disease (MI, PAD, aortic plaque)	1
Age 65–74	1
Sex category female	1

Score	Approx. annual stroke risk
0	0%
1	1.3%
2	2.2%
3	3.2%
4	4.0%
5	6.7%
6	9.8%
7	9.6%
8	6.7%
9	15.2%

CHA₂DS₂-VASc Score Calculator

How the score is built

Annual stroke risk by score

Common questions