CHA2DS2-VASc Calculator
CHA2DS2-VASc is a validated clinical scoring tool that estimates annual stroke risk in patients with non-valvular atrial fibrillation, guiding the decision to initiate anticoagulation therapy. Each risk factor is assigned 1 or 2 points: prior stroke or TIA and age 75+ each contribute 2 points, while heart failure, hypertension, diabetes, vascular disease, age 65-74, and female sex each contribute 1 point. Total score ranges from 0 to 9. The ACC/AHA and ESC recommend anticoagulation for men with score of 2 or above and women with score of 3 or above. This calculator is for educational reference only; anticoagulation decisions require full clinical evaluation.
CHA2DS2-VASc scoring
Score = CHF(1) + HTN(1) + Age75+(2) + DM(1) + Stroke/TIA(2) + Vasc(1) + Age65-74(1) + Female(1)
Maximum: 9 points
Note: Age 75+ and Age 65-74 are mutually exclusive. If the patient is 75 or older, score 2 for Age 75+ and 0 for Age 65-74. Female sex adds 1 point only if at least one other risk factor is present (score is not meaningful as an isolated sex point).
Anticoagulation recommendations (ACC/AHA 2023)
- Score 0 (male) or 1 (female only): Anticoagulation not recommended.
- Score 1 (male) or 2 (female): Consider anticoagulation; discuss benefits and bleeding risks.
- Score 2+ (male) or 3+ (female): Anticoagulation recommended unless contraindicated.
- Preferred agents: DOACs (apixaban, rivaroxaban, dabigatran, edoxaban) over warfarin for non-valvular AFib.
Frequently asked questions
What is the CHA2DS2-VASc score?
CHA2DS2-VASc is a clinical scoring system used to estimate stroke risk in patients with non-valvular atrial fibrillation (AFib). It guides the decision to initiate anticoagulation therapy. The acronym: C=Congestive heart failure, H=Hypertension, A2=Age 75+, D=Diabetes, S2=prior Stroke/TIA, V=Vascular disease, A=Age 65-74, Sc=Sex category (female).
What score threshold warrants anticoagulation?
Current ACC/AHA guidelines recommend anticoagulation for men with CHA2DS2-VASc score of 2 or above and for women with score of 3 or above. Score 1 in men (or 2 in women, counting only the sex point) warrants discussion of anticoagulation. Score 0 in men requires no treatment.
How is each criterion scored?
C (heart failure): 1 point. H (hypertension): 1 point. A2 (age 75+): 2 points. D (diabetes): 1 point. S2 (prior stroke or TIA): 2 points. V (vascular disease - prior MI, PAD, or aortic plaque): 1 point. A (age 65-74): 1 point. Sc (female sex): 1 point. Maximum total: 9 points.
What anticoagulants are used for AFib?
Direct oral anticoagulants (DOACs: apixaban, rivaroxaban, dabigatran, edoxaban) are preferred over warfarin for non-valvular AFib in current guidelines due to similar or superior efficacy and safety. Warfarin (with INR monitoring) remains appropriate for certain conditions including mechanical heart valves and severe renal impairment.
What is HAS-BLED and how does it relate to CHA2DS2-VASc?
HAS-BLED is a bleeding risk score used alongside CHA2DS2-VASc to assess the net benefit of anticoagulation. A high HAS-BLED score does not automatically contraindicate anticoagulation but rather highlights modifiable bleeding risk factors to address. Guidelines recommend anticoagulation for most AFib patients with CHA2DS2-VASc score of 2 or above unless absolute contraindications exist.
Official sources
- American Heart Association / ACC: AFib and Blood Thinners.
- NIH National Heart, Lung, and Blood Institute: Atrial Fibrillation Overview.
Reviewed by the CalculatorHub team, edited by James Graham, 15 June 2026. See our methodology.