CHA2DS2-VASc scoring system for atrial fibrillation

CHA2DS2-VASc scoring system for atrial fibrillation

CHA₂DS₂-VASc risk factor based point scoring system for atrial fibrillation is meant for assessing the risk of thromboembolism in nonvalvular atrial fibrillation. Major risk factors (previous stroke, TIA or systemic embolism and age 75 years or more) are given a score of two points while other clinically relevant non-major risk factors (congestive heart failure or moderate to severe left ventricular systolic dysfunction [left ventricular ejection fraction of 40% or less], hypertension, diabetes mellitus, age between 65-74 years, female sex and vascular disease [prior myocardial infarction, peripheral artery disease or aortic plaque]) are given one point each.

• • Congestive heart failure / LV dysfunction: 1
  • Hypertension: 1
  • Age 75 or more: 2
  • Diabetes mellitus: 1
  • Stroke/TIA/thromboembolism: 2
  • Vascular disease: 1
  • Age 65-74: 1
  • Sex category (female sex): 1

Maximum score: 9

CHA₂DS₂-VASc score is an improvement from the CHADS2 score. The risk increases as the score increases from 0 to 9. In a study involving over 7300 patients stroke rate was 0 when the score was 0, though there was only one patient in that category. There were fourteen patients with a score of nine and they had stroke rate of 15.2%. Maximum number of patients scores of 3 and 4 with 1730 and 1718 patients in these categories. Score 3 had a stroke rate of 3.2% and score 4 had a stroke rate of 4% [1].

Reference

1. European Heart Rhythm Association; European Association for Cardio-Thoracic Surgery, Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, Ernst S, Van Gelder IC, Al-Attar N, Hindricks G, Prendergast B, Heidbuchel H, Alfieri O, Angelini A, Atar D, Colonna P, De Caterina R, De Sutter J, Goette A, Gorenek B, Heldal M, Hohloser SH, Kolh P, Le Heuzey JY, Ponikowski P, Rutten FH. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010 Oct;31(19):2369-429.