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Atrial Fibrillation CHADS2 Stroke Risk Index

CHADS2 Stroke Risk Index:
  • Risk prediction tool for stroke in patients with the heart rhythm disturbance, atrial fibrillation.
  • The CHADS2 (Congestive heart failure, Hypertension, Age, Diabetes, Stroke) index.
  • It assigns 1 point each for a history of heart failure, hypertension, age > 75 years, & diabetes mellitus.
  • 2 points is awarded for a history of stroke or transient ischemic attack (see table below).

Condition Points
C Congestive heart failure 1
H Hypertension (or treated hypertension) 1
A Age > 75 years 1
D Diabetes 1
S2 Prior stroke or TIA 2

Patient Assessment Based on CHADS2 Score:
  • Patients can be classified in to low, moderate or moderate/high risk for stroke.
  • Low risk (score 0).
  • Moderate risk (score 1).
  • Moderate/high risk (score 2 or greater).
  • The guidelines state that therapy with either warfarin or aspirin is reasonable for a patient with 1 moderate risk factor.
  • Predicted annual stroke risks for CHADS2 scores are shown in the table below.
Points Annual Stroke Risk 95% CI
0 1.9% 1.2-3.0
1 2.8% 2.0-3.8
2 4.0% 3.1-5.1
3 5.9% 4.6-7.3
4 8.5% 6.3-11.1
5 12.5% 8.2-17.5
6 18.2% 10.5-27.4

References:
Gage BF, Waterman AD, Shannon W, et al. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001; 285:2864-2870.


Tags:

Age - Aspirin - Atrial Fibrillation - CHADS2 - Congestive Heart Failure - Diabetes Mellitus - Hypertension - Stroke - Stroke Risk Index - TIA - Warfarin


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