CHA₂DS₂‑VASc score

Calculate Stroke Risk for Patients with Atrial Fibrillation

Advice

The inclusion of sex as an independent risk factor for ischemic stroke in patients with AF has been controversial, so we have removed it here.

Anticoagulation is strongly beneficial for stroke prevention in Atrial Fibrillation (AF), while antiplatelet monotherapy (like Aspirin) is not supported by current evidence.

Critical Actions Before Treatment

1. Assess Bleeding Risk: Use validated tools (e.g., HAS-BLED or ORBIT) and address reversible risk factors for bleeding immediately.

2. Shared Decision-Making: Weigh the risks and benefits of anticoagulation (preferably with a DOAC) carefully, and discuss them thoroughly with the patient. The risk-benefit ratio usually remains favorable even with some bleeding risk.