CHA₂DS₂-VASc

Stroke risk in non-valvular AF. Drives anticoagulation decisions + perioperative AC hold timing.

C — Congestive heart failure

Recent decompensation, EF ≤ 40%, or HFpEF/HFrEF history

H — Hypertension

BP > 140/90 on at least 2 occasions or on antihypertensive treatment

A₂ — Age ≥ 75 (2 points)

D — Diabetes mellitus

Fasting glucose ≥ 125 or treated

S₂ — Prior stroke / TIA / thromboembolism (2 points)

V — Vascular disease

Prior MI, peripheral artery disease, or aortic plaque

A — Age 65-74 (1 point if not ≥75)

Sc — Sex category (female)

Note: low CHA2DS2-VASc score in women may not require AC

Score

0 / 9

No anticoagulation routinely recommended

Show working

0 C Congestive HF
0 H Hypertension
0 A₂ Age ≥ 75 (2 pts)
0 D Diabetes
0 S₂ Stroke/TIA (2 pts)
0 V Vascular disease
0 A Age 65-74 (if not ≥75)
0 Sc Sex (female)
Total: 0
Estimated annual stroke risk: ~0.2%
No anticoagulation recommended (0)

Periop note: Patients on chronic AC for AF require coordinated periop hold per ASRA + cardiology. Bridge with LMWH only if mechanical valve or very high stroke risk. DOACs simply held 24-72h depending on agent + renal function. Use crisis algorithms reference for emergency reversal.