CHA₂DS₂-VASc Calculator

The CHA₂DS₂-VASc calculator is a clinical tool to assess the risk of stroke in people suffering from non-rheumatic atrial fibrillation. Nonrheumatic atrial fibrillation is a disorder associated with severe arrhythmia and thromboembolic strike. This CHA₂DS₂-VASc calculator helps to evaluate the need for anticoagulation treatment for such patients. It is the added version of chads2, which follows the risk factors associated with the stroke.

Atrial fibrillation can cause blood stasis in upper heart chambers, forming a mural thrombosis. These thrombi can move from the heart chambers to the brain, disturbing the blood flow. In this way, it can cause a stroke. This article highlights the basic information and integrated details related to the CHA₂DS₂-VASc calculator. Let us have an elaborate look at the key features of the CHA₂DS₂-VASc calculator.

What is the simplified version of the CHA₂DS₂-VASc calculator?

The CHA₂DS₂-VASc calculator is an abbreviation of the different risk factors associated with stroke. These are as follows:

C stands for congestive heart failure

H stands for hypertension

A stands for age ( >65 years represents 1 point, whereas >75 years demarcates 2 points)

D stands for diabetes mellitus

S stands for the history of previous stroke or transient ischemic attack

V stands for any vascular disorder, including peripheral arterial disease, history of myocardial infarction, or aortic atheroma)

A stands for the age of the patient

Sc indicates the sex category of the patient

How can we use this CHA₂DS₂-VASc calculator?

The name of the CHA₂DS₂-VASc calculator indicates the various risk factors associated with non-rheumatic atrial fibrillation. Every risk factor holds one point if it is present except for the age of the patient, which has two points. Let’s explain the scoring point in detail.

• Congestive heart failure – if present, it counts as 1 point.
• Hypertension – if present, it also counts as 1 point.
• Age greater than 75 adds two points to the score. Whereas age less than 75 adds 1 point to the total score.
• Diabetes mellitus adds one point.
• Any past history of stroke, thromboembolism, or TIA also adds two points to the CHA₂DS₂-VASc score.
•  Vascular diseases which are usually peripheral artery disease, aortic plaques, or myocardial also add one point.
• A sex category like female adds one point to the score.

The maximum score of the CHA₂DS₂-VASc calculator is 9. The more the score, the more the chances for the management of anticoagulation therapy.

What does this CHA₂DS₂-VASc calculator score indicate?

The CHA₂DS₂-VASc score is important to assess the need for anticoagulation treatment in patients with non-rheumatic atrial fibrillation. The lower end of the scale indicates that there is no need for anticoagulation therapy for the patient. So according to this, a male, with a 0 score does not need to go for anticoagulation therapy. In addition, for females, a CHA₂DS₂-VASc score of 1 is normal and does not need any additional therapy.

There is a medium type of risk if the male score rises to level one. Whereas, a female of score two or more is considered as high risk and requires anticoagulation treatment.

What is the annual stroke risk following the CHA₂DS₂-VASc score?

According to different studies, the annual stroke risk following the CHA₂DS₂-VASc score is as follows:

CHA₂DS₂-VASc calculator score:	Stroke risk per year:
0	0
1	1.3%
2	2.2%
3	3.2%
4	4.0%
5	6.7%
6	9.8%
7	9.6%
8	6.7% due to a very small sample size
9	15.2%

This study data was provided by Lip and other colleagues. In contemporary cohorts, this adjusted stroke date may vary.

What is the treatment plan according to the CHA₂DS₂-VASc calculator score?

The treatment plan varies for low-risk to high-risk patients. Anticoagulation therapy is recommended for medium to high-risk patients.

CHA₂DS₂-VASc score:	Risk regimen:	Treatment plan:
0 (male) 1 (female)	Low	No such additional therapy is required
1 (male):	Moderate	No treatment / aspirin or oral anticoagulants may recommend following the conditions of the patient
2 or more than 2	High	Oral anticoagulants

Why is the CHA₂DS₂-VASc calculator important?

The CHA₂DS₂-VASc calculator is important for the patients and the physicians to properly guide the patients regarding stroke risk. It is an excellent tool to educate patients regarding the risk of stroke. Many patients hesitate to start anticoagulant therapy due to inconvenience. This score calculator explains that the CHA₂DS₂-VASc score of 4 is equal to the 40% risk of stroke in the next 10 years. It helps to convince the patients regarding the anticoagulation treatment.

What are the possible risks or side effects associated with anticoagulation therapy?

Anticoagulants are actually blood thinners that help to prevent blood clotting in different blood vessels. Besides the benefit, it increases the chances of bleeding risk. There is also another scoring system (HAS-BLED) to evaluate the risk of bleeding in people using anticoagulants for atrial fibrillation. High-risk patients are always regulated properly and maintained follow-up to avoid the side effects of anticoagulants. Patients with a score of 3 or greater than 3 are at high risk of bleeding. It does not mean they cannot take anticoagulants but they need some risk factors to modify.

Conclusion

A CHA₂DS₂-VASc calculator is a diagnostic tool for the assessment of stroke risk. It is a combination of different risk factors that increases the chance of stroke in patients with atrial fibrillation. This CHA₂DS₂-VASc calculator also depends on gender. A score of 0 for males or 1 for females is low-risk and does not require any anticoagulant therapy. In addition, a score of 1 is medium risk and does not require further treatment. Whereas, a score of 2 or more indicates high-risk patients. These are the patients that require anticoagulant therapy.

This article is all about the CHA₂DS₂-VASc calculator and the associated factors. Focus on the details to understand the concepts of the CHA₂DS₂-VASc score.

Frequently asked questions (FAQs)