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Lesson 5 of 8
In Progress

Assessment of Thromboembolic Risk

  • AF favors formation of intra-atrial thrombi so possibility of thromboembolism should be assessed
  • Management: OAC drugs to decrease risk of stroke in AF

Stroke Risk Assessment using CHA2DS2-VASc score

  • developed for stratification of stroke risk with AF
  • identifies the patient’s associated risk factors
  • beneficial to understanding the potential AF treatment management with OAC
CHA2DS2-VASc Risk Score
CHF or LVEF <40% 1
Hypertension 1
Age >75 2
Diabetes 1
Stroke / TIA / Thromboembolism 2
Vascular disease 1
Age 65 – 74 1
Sex Category: Female 1

 

Anticoagulation Recommendation for AF

Based on CHA2DS2-VASc Scoring System

CHA2DS2-VASc Score Recommendation
≥ 2 Oral anticoagulants are recommended
1 Either anticoagulation, no therapy, aspirin
0 No antithrombotic therapy

Bleeding Risk Assessment using HAS-BLED score

  • identifies the precautionary measures that should be taken prior to OAC
Clinical Characteristics Score
Hypertension (Uncontrolled) 1
Abnormal liver or renal functions (1 point each) 1 or 2
Stroke 1
Bleeding 1
Labile INRs 1
Elderly (Age > 65) 1
Drugs (aspirin, clopidogrel, NSAIs, etc) or alcohol

(1 point each)

1 or 2

 

HAS-BLED Score Bleeding Risk (%)
0 1
1 2
2 3
3 4
4 9
>5 13