What is the CHA2DS2-VASc score used to do?
The CHA2DS2-VASc score is used to initially identify low risk patients who do not need antithrombotic therapy, rather than focus on identification of high risk patients. The C in CHA2DS2-VASc refers to recent decompensated HF, irrespective of the ejection fraction (thus including HF with reduced ejection fraction or HF with preserved ejection fraction) or the presence of moderate-severe left ventricular systolic impairment on cardiac imaging, whether symptomatic or asymptomatic. The H refers to history of hypertension or uncontrolled BP, while S refers to stroke, systemic embolism, or a confirmed diagnosis of TIA. V refers to complicated vascular disease, including MI or PAD, or if performed, the presence of complex aortic plaque on TEE. Female sex (Sc criterion) is only relevant as a risk modifier if age > 65 or additional associated risk factors are present, given that females age < 65 with no other risk factors are not at excess stroke risk.