CHA₂DS₂-VA Score Calculator
2024 ESC Guidelines for Atrial Fibrillation
Annual Stroke Risk: 0.5% (Very Low)
With NOAC: ~0.2%
Stroke Risk With and Without Anticoagulation
Annual stroke risk for patients with atrial fibrillation, based on their CHA₂DS₂-VA score:
| Score | Annual Risk without OAC |
Estimated stroke risk while on NOAC* |
Risk Category |
|---|---|---|---|
| 0 | 0.5% | ~0.2% | Very Low |
| 1 | 1.5% | ~0.5% | Low |
| 2 | 2.9% | ~1.0% | Moderate |
| 3 | 5.1% | ~1.8% | Moderate |
| 4 | 7.3% | ~2.6% | High |
| 5 | 11.2% | ~3.9% | High |
| 6 | 15.5% | ~5.4% | Very High |
| 7 | 14.7% | ~5.1% | Very High |
| 8 | 19.5% | ~6.8% | Very High |
Annual stroke rates from the FinACAF study11
*Based on average 65% risk reduction in clinical trials using CHA₂DS₂-VASc score12,13
2024 ESC Guideline Recommendations
Score ≥2: Anticoagulation is recommended (Class I)
Score = 1: Anticoagulation should be considered (Class IIa)
Score = 0: No anticoagulation indicated
References
ESC AF Guideline 2024: For further information on the CHA₂DS₂-VA score, refer to the 2024 ESC Guidelines. Read the full guideline here.
1. Chung S, et al. Stroke and systemic embolism and other adverse outcomes of heart failure with preserved and reduced ejection fraction in patients with atrial fibrillation. Am J Cardiol 2020;125:68–75. Read here.
2. Uhm JS, et al. Stroke and systemic embolism in patients with atrial fibrillation and heart failure according to heart failure type. ESC Heart Fail 2021;8:1582–9. Read here.
3. McMurray JJ, et al. Left ventricular systolic dysfunction, heart failure, and the risk of stroke and systemic embolism in patients with atrial fibrillation. Circ Heart Fail 2013;6:451–60. Read here.
4. McEvoy JW, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J 2024. Read here.
5. Kim D, et al. Ideal blood pressure in patients with atrial fibrillation. J Am Coll Cardiol 2018;72:1233–45. Read here.
6. Lip GY, et al. Stroke and major bleeding risk in elderly patients aged ≥75 years with atrial fibrillation: the Loire valley atrial fibrillation project. Stroke 2015;46:143–50. Read here.
7. American Diabetes Association. Classification and diagnosis of diabetes: standards of medical care in diabetes—2022. Diabetes Care 2022;45:S17–38. Read here.
8. Steensig K, et al. Should the presence or extent of coronary artery disease be quantified in the CHA2DS2-VASc score in atrial fibrillation? Thromb Haemost 2018;118:2162–70. Read here.
9. Zabalgoitia M, et al. Transesophageal echocardiographic correlates of clinical risk of thromboembolism in nonvalvular atrial fibrillation. J Am Coll Cardiol 1998;31:1622–6. Read here.
10. Stroke Prevention in AF Investigators. Transesophageal echocardiography in atrial fibrillation. J Am Soc Echocardiogr 1996;9:556–66. Read here.
11. Teppo K, et al. Comparing CHA2DS2-VA and CHA2DS2-VASc scores for stroke risk stratification in patients with atrial fibrillation: a temporal trends analysis from the retrospective Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) cohort. Lancet Reg Health Eur 2024;43:100957. Read here.
12. Hart RG, et al. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007;146:857-67. Read here.
13. Ruff CT, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 2014;383:955-62. Read here.