- 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 |