The CHA2DS2-VASc score

 Although simple, the CHADS2 score does not include many common stroke risk factors, and its limitations have been highlighted by its non-inclusion of common stroke risk factors. Even patients classified as low risk by CHADS2 in its original validation study have a stroke rate of 1.9% per year, which is close to the criterion of a cardiovascular event rate of 20% over 10 years for primary prevention strategies.

Consequently, CHADS2 was expanded to include three additional independent risk factors: vascular disease (coronary artery disease, peripheral artery disease, aortic atherosclerosis), age 65-74 years, and female sex. 

This new, more inclusive scoring system is the CHA2DS2-VASc score. 

The CHA2DS2-VASc score better discriminated stroke risk in nonvalvular AF subjects with a baseline CHADS2 score of 0 to 1

Table 3. CHA₂DS₂-VASc Score and Risk Criteria 

Score	CHA2DS2-VASc Risk Criteria
1 point	Congestive heart failure
1 point	Hypertension
2 points	Age ≥75 years
1 point	Diabetes mellitus
2 points	Stroke/Transient Ischemic Attack/Thromboembolic event
1 point	Vascular disease (prior MI, PAD, or aortic plaque)
1 point	Age 65 to 74 years
1 point	Sex category (ie, female sex)