Such a score is used to determine whether or not treatment is required with anticoagulation therapy or antiplatelet therapy,[1] since AF can cause stasis of blood in the upper heart chambers, leading to the formation of a mural thrombus that can dislodge into the blood flow, reach the brain, cut off supply to the brain, and cause a stroke.
The CHA2DS2-VASc score is a widely used medical tool used to guide physicians on blood thinning treatment to prevent stroke in people with non-valvular atrial fibrillation (AF).
[6] Adding together the points that correspond to the conditions that are present results in the CHADS2 score, that is used to estimate stroke risk.
However, actual risk of getting stroke varies according to sampling method and geographical regions, as well as use of appropriate study analysis methodology.
[14] Nevertheless, stroke rates vary by study setting (hospital vs community), population (trial vs general), ethnicity, etc.
[16] The predictive abilities of risk scores for ischemic stroke in patients with kidney function impairment is questionable: a large head-to-head external validation study demonstrated poor discrimination and calibration in patients with reduced kidney function.
[19][20][21] The inclusion of sex as a risk factor has been debated, particularly regarding its implications for clinical decision-making and its applicability to individuals who are non-binary, transgender, or undergoing hormone therapy.
[26] The European Society of Cardiology (ESC),[25] and National Institute for Health and Care Excellence (NICE)[27] guidelines recommend that if the patient has a CHA2DS2-VASc score of 2 and above, oral anticoagulation therapy (OAC) with a vitamin K antagonist (VKA, e.g. warfarin with target INR of 2-3) or one of the direct oral anticoagulant drugs (DOACs, e.g. dabigatran, rivaroxaban, edoxaban, or apixaban) is recommended.