CHA2DS2–VASc Assesses Stroke Risk
Score Calculation: 1 point each for HF, HTN, DM, vascular disease, age 65-74 y, female sex; 2 points each for age ≥ 75 y, hx of stroke.
Antithrombotic Treatment by Score:
0 = ASA or no treatment
1 = ASA or Anticoagulant1 or no treatment
≥ 2 = Anticoagulant1
HAS-BLED Assesses Bleeding Risk of Anticoagulant Treatment
Score Calculation: 1 point each for HTN, abnormal renal function, abnormal liver function, prior stroke, prior major bleeding, labile INRs, age ≥65, alcohol use, drug use
Antithrombotic Treatment by Score:
If CHADS2 or CHA2DS2–VASc score is 1, the risk of bleeding with anticoagulant treatment may outweigh the risk of stroke if the HAS-BLED score is >2.
If CHADS2 or CHA2DS2–VASc score is ≥2, the risk of bleeding from anticoagulant treatment may outweigh the risk of stroke if the HAS-BLED score exceeds the CHADS2 or CHA2DS2–VASc score.
If the CHA2DS2–VASc score is 1, the risk of bleeding with anticoagulant treatment may outweigh the risk of stroke if the HAS–BLED score is >2. In patients at high risk for both stroke and bleeding based on the CHA2DS2–VASc and HAS–BLED scores, shared decision-making is recommended to guide therapy; such patients may be suitable candidates for a left atrial appendage occlusion device.
1 Apixaban, dabigatran, edoxaban, rivaroxaban, or warfarin