Study note
MedicineCardiology

CHA₂DS₂-VA scoring for stroke risk in non-valvular atrial fibrillation

THE CONTEXT
This scoring system assigns points to clinical stroke risk factors and links the total to annual stroke risk and oral anticoagulation decisions.

Point allocation

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Congestive heart failure, hypertension history, diabetes mellitus and vascular disease each contribute 1 point.
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Age 65–74 years contributes 1 point; age of at least 75 years contributes 2 points.
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Previous stroke or transient ischaemic attack contributes 2 points.
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The maximum total score is 8 points.

Interpretation and prophylaxis

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A score of 0 corresponds to an annual stroke risk of 0%; no prophylaxis is required.
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A score of 1 corresponds to an annual stroke risk of 1.3%; consider an oral anticoagulant.
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A score of 2 or more corresponds to an annual stroke risk greater than 2.2%; an oral anticoagulant is recommended.
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