CHA₂DS₂-VASc Calculator — AF Stroke Risk Score
The CHA₂DS₂-VASc score estimates annual ischaemic stroke risk in non-valvular atrial fibrillation. Enter patient characteristics to get the score (0–9), an estimated annual stroke-risk percentage, and anticoagulation guidance aligned with ESC 2020 guidelines.
years
Sex
Congestive heart failure or LV dysfunction
Hypertension (BP ≥ 140/90 or treated)
Diabetes mellitus
Prior stroke, TIA, or thromboembolism
Vascular disease (prior MI, peripheral artery disease, or aortic plaque)
Oral anticoagulation recommended (score ≥2)
- 1
Clinical risk factors
CHF(0) + HTN(1) + Diabetes(0) + Vascular(0) + Stroke/TIA(0) = 1Prior stroke/TIA contributes 2 points; all other clinical factors contribute 1 each. - 2
Age component
Age 65–74 → +1 = +1 - 3
Female sex component
+0 - 4
CHA₂DS₂-VASc total score
1 + 1 + 0 = 2
How does this calculator work?
CHA₂DS₂-VASc scores AF patients 0–9 by adding points for CHF, hypertension, age ≥75 (×2), diabetes, prior stroke/TIA (×2), vascular disease, age 65–74, and female sex. Annual stroke risk ranges from ~0% (score 0) to ~15% (score 9). ESC 2020 recommends anticoagulation at score ≥2 (men) or ≥3 (women with at least one independent clinical risk factor).
Formula
How this is calculated
CHA₂DS₂-VASc is a validated clinical risk-stratification tool for estimating annual ischaemic stroke risk in patients with non-valvular atrial fibrillation (AF). It supersedes the earlier CHADS₂ score by adding three additional risk modifiers — vascular disease, age 65–74, and female sex — which improves identification of truly low-risk patients. The acronym covers: Congestive heart failure or left ventricular dysfunction, Hypertension (BP ≥140/90 mmHg or on treatment), Age ≥75 years (worth 2 points), Diabetes mellitus, prior Stroke or TIA or systemic thromboembolism (worth 2 points), Vascular disease (prior MI, peripheral artery disease, or aortic plaque), Age 65–74 years, and Sex category female.
Annual stroke-risk percentages used here are derived from the Danish Nationwide Cohort study by Olesen et al. (Thromb Haemost 2011): score 0 ≈0%, 1 ≈1.3%, 2 ≈2.2%, 3 ≈3.2%, 4 ≈4.0%, 5 ≈6.7%, 6 ≈9.8%, 7 ≈9.6%, 8 ≈12.5%, 9 ≈15.2%. These are population-level estimates from 2010–2011 administrative data; absolute risks vary with patient characteristics and modern treatment.
ESC 2020 guidelines recommend: no anticoagulation for men with score 0 or women whose only risk factor is female sex (score 1 from sex alone); consider anticoagulation for men with score 1; recommend oral anticoagulation for score ≥2 in men and ≥3 in women (i.e., at least one independent clinical risk factor beyond female sex). Bleeding risk should always be weighed using the HAS-BLED score; this tool is a clinical decision-support aid, not a substitute for clinician judgment.
Frequently asked questions
Not necessarily. If the only point comes from female sex with no other clinical risk factors, ESC 2020 guidelines do not recommend anticoagulation. For a score of 1 in a male patient (one clinical risk factor), anticoagulation can be considered. Always weigh bleeding risk with the HAS-BLED score and discuss with the patient.
CHADS₂ (2001) scores five risk factors on a 0–6 scale. CHA₂DS₂-VASc (2010) adds vascular disease, age 65–74, and female sex to produce a 0–9 scale, improving its ability to identify truly low-risk patients (score 0) who can safely avoid anticoagulation.
Direct oral anticoagulants (DOACs — apixaban, rivaroxaban, dabigatran, edoxaban) are preferred over vitamin K antagonists (warfarin) in non-valvular AF per current ESC, AHA, and ACC guidelines because of predictable effect, fewer drug interactions, and no need for routine INR monitoring. Choice depends on renal function, adherence, and other clinical factors.
TG we-Calculate Editorial Team. (2026). CHA₂DS₂-VASc Calculator — AF Stroke Risk Score [Online calculator]. TG we-Calculate. https://we-calculate.com/calculator/cha2ds2-vasc-calculator
TG we-Calculate Editorial Team. "CHA₂DS₂-VASc Calculator — AF Stroke Risk Score." TG we-Calculate. 2026. https://we-calculate.com/calculator/cha2ds2-vasc-calculator.
TG we-Calculate Editorial Team, "CHA₂DS₂-VASc Calculator — AF Stroke Risk Score," TG we-Calculate, 2026. [Online]. Available: https://we-calculate.com/calculator/cha2ds2-vasc-calculator
@misc{wecalculate_cha2ds2_vasc_calculator, title = {CHA₂DS₂-VASc Calculator — AF Stroke Risk Score}, author = {{TG we-Calculate Editorial Team}}, howpublished = {\url{https://we-calculate.com/calculator/cha2ds2-vasc-calculator}}, year = {2026}, note = {TG we-Calculate} }
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