Impact of the CHA2DS2-VASc Score on Anticoagulation Recommendations for Atrial Fibrillation

The Congestive heart failure, Hypertension, Age≥75 years, Diabetes mellitus, Stroke (CHADS2) score is used to predict the need for oral anticoagulation for stroke prophylaxis in patients with atrial fibrillation. The Congestive heart failure, Hypertension, Age≥75 years, Diabetes mellitus, Stroke, Vascular disease, Age 65-74 years, Sex category (CHA2DS2-VASc) schema has been proposed as an improvement. Our objective is to determine how adoption of the CHA2DS2-VASc score alters anticoagulation recommendations. Between 2004 and 2008, 1664 patients were seen at the University of Virginia Atrial Fibrillation Center. We calculated the CHADS2 and CHA2DS2-VASc scores for each patient. The 2006 American College of Cardiology/American Heart Association/Heart Rhythm Society guidelines for atrial fibrillation management were used to determine anticoagulation recommendations based on the CHADS2 score, and the 2010 European Society of Cardiology guidelines were used to determine anticoagulation recommendations based on the CHA2DS2-VASc score. The average age was 62±13 years, and 34% were women. Average CHADS2 and CHA2DS2-VASc scores were 1.1±1.1 and 1.8±1.5, respectively (P