Practical-Manual-Scores-Algorithms-Haemostasis-Thrombosis

Prediction of stroke risk in patientswith atrial fibrillationIndicationAtrial fibrillation (AF) is the most common arrhythmia in the population, and is amajor cause of stroke and systemic thromboembolism. Whilst the risk of strokein AF is increased 5-fold, stroke risk in AF is not homogeneous.Atrial FibrillationThe CHADS 2and CHA 2DS 2-VASc stroke risk score calculators have beenused to aid risk stratifying of patients, and to help decision making forthromboprophylaxis. The CHA 2DS 2-VASc score is now recommended bymany international guidelines, including those from the ESC, AHA/ACC/HRS,APHRS, SIGN and NICE guidelines.InterpretationLow risk = 0Moderate risk = 1High risk ≥ 2CHADS 2risk scoreRisk factorScoreCongestive heart failure 1Hypertension 1Age ≥ 75 years 1Diabetes mellitus 1Prior Stroke or TIA or Thromboembolism 2The CHADS 2score has been replaced by the CHA 2DS 2-VASc score in thelatest guidelines from the ESC, AHA/ACC/HRS, NICE, etc. Older guidelines(e.g. the 2006 ACC/AHA/ESC guidelines) recommended the following:CHADS 2scoreAntithrombotic therapy recommendation> 1 OAC (vitamin K antagonist or dabigatran)1 OAC or ASA 75-325 mg/day0 ASAOAC: oral anticoagulant; NOAC: Non-VKA Oral AntiCoagulants (previously called New or novel OACs);ASA: Acetylsalicylic Acid25