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German: CHA2DS2-VASc-Score

1 Definition

CHA2DS2-VASc-Score is a modification of the CHADS2-Score which is mainly used in Europe. As the CHADS2-Score, it serves the stroke risk evaluation in atrial fibrillation.

The usefulness of this score is discussed controversially.

2 Background

The CHA2DS2-VASc-Score admits a slightly finer differentiation in patients with low stroke risk, and thus it allows for a better risk stratification.

In contrast to the CHADS2-Score, additional points for eventual vascular diseases and female gender are given. Moreover, a more exact differentiation of the age is possible: from 65 years on, one point is given, and from 75 years on another point. In women under 65 years without further risk factors, female gender represents no stand-alone risk factor (score = 0 points).

In summary, the CHA2DS2-VASc-Score is calculated fromthe following parameters:

  • Congestive heart failure (1 point)
  • Hypertension (1 point)
  • Age (> 75 = 2 points)
  • Diabetes mellitus (1 point)
  • Stroke/TIA (2 points)
  • Vascular disease - eg. PAD, previous myocardial infarction, severe calcification of the aorta) (1 point)
  • Age: 65-74 (1 point)
  • Sex category: women (1 point)

Patients who suffer from atrial fibrillation and have at least 2 points in the CHA2DS2-VASc-Score are suggested for oral anticoagulation with coumarins, recently also with direct oral anticoagulants. In patients with 1 point in the score, coumarins are also indicated already, however, as a 2nd choice, you can still give ASS. Patients with a score of 0 are in no need of anticoagulant therapy despite atrial fibrillation. In some individual cases, ASS is given.

To be able to estimate the risk of bleeding due to oral anticoagulation, another score has been suggested: the HAS-BLED-Score.

This page was last edited on 17 October 2016, at 10:27.

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