CHA₂DS₂-VASc Score | Risk of ischemic stroke | Risk of stroke/TIA/systemic embolism |
---|---|---|
0 | 0.2% | 0.3% |
1 | 0.6% | 0.9% |
2 | 2.2% | 2.9% |
3 | 3.2% | 4.6% |
4 | 4.8% | 6.7% |
5 | 7.2% | 10.0% |
6 | 9.7% | 13.6% |
7 | 11.2% | 15.7% |
8 | 10.8% | 15.2% |
9 | 12.2% | 17.4% |
Article: Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation.
Lip GY1, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Chest. 2010 Feb;137(2):263-72. doi: 10.1378/chest.09-1584. Epub 2009 Sep 17. |
HAS-BLED Score | Risk group | Risk of major bleeding | Bleeds per 100 patient-years | Recommendation |
---|---|---|---|---|
0 | Relatively low | 0.9% | 1.13 | Anticoagulation should be considered |
1 | 3.4% | 1.02 | ||
2 | Moderate | 4.1% | 1.88 | Anticoagulation can be considered |
3 | High | 5.8% | 3.72 | Alternatives to anticoagulation should be considered |
4 | 8.9% | 8.70 | ||
5 | 9.1% | 12.50 | ||
>5* | Very high | -- | -- | |
*Scores greater than 5 were too rare to determine risk, but are likely over 10%. Article: A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Pisters R1, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. Chest. 2010 Nov;138(5):1093-100. doi: 10.1378/chest.10-0134. Epub 2010 Mar 18. |
Haemorrhagic risk | Stroke risk | Clinical setting | Recommendations according to EHRA / ESC / EAPCI 2014 consensus document |
---|---|---|---|
Low or moderate (HAS-BLED 0-2) |
Moderate (CHA2DS2-VASC = 1 in males) |
Stable CAD |
At least 4 weeks (no longer than 6 months): triple therapy of OAC + aspirin 75-100 mg/day + clopidogrel 75 mg/day
Up to 12th month: OAC and clopidogrel 75 mg/day (or alternatively, aspirin 75-100 mg/day)
Lifelong: OAC
|
High (CHA2DS2-VASC ≥2) |
Stable CAD |
At least 4 weeks (no longer than 6 months): triple therapy of OAC + aspirin 75-100 mg/day + clopidogrel 75 mg/day
Up to 12th month: OAC and clopidogrel 75 mg/day (or alternatively, aspirin 75-100 mg/day)
Lifelong: OAC
|
|
Moderate (CHA2DS2-VASC = 1 in males) |
ACS |
6 months: triple therapy of OAC + aspirin 75-100 mg/day +
clopidogrel 75 mg/day
Up to 12th month: OAC and clopidogrel 75 mg/day (or alternatively, aspirin 75-100 mg/day)
Lifelong: OAC
| |
High (CHA2DS2-VASC ≥2) |
ACS |
6 months: triple therapy of OAC + aspirin 75-100 mg/day + clopidogrel 75 mg/day
Up to 12th month: OAC and clopidogrel 75 mg/day (or alternatively,
aspirin 75-100 mg/day)
Lifelong: OAC
|
|
High (HAS-BLED ≥3) |
Moderate (CHA2DS2-VASC = 1 in males) |
Stable CAD |
Up to 12th month: OAC and clopidogrel 75 mg/day
Lifelong: OAC
|
High (CHA2DS2-VASC ≥2) |
Stable CAD |
4 weeks: triple therapy of OAC + aspirin 75-100 mg/day + clopidogrel 75 mg/day
Up to 12th month: OAC and clopidogrel 75 mg/day (or alternatively, aspirin 75-100 mg/day)
Lifelong: OAC
|
|
Moderate (CHA2DS2-VASC = 1 in males) |
ACS |
4 weeks: triple therapy of OAC + aspirin 75-100 mg/day + clopidogrel 75 mg/dayd
Up to 12th month: OAC and clopidogrel 75 mg/day (or alternatively, aspirin 75-100 mg/day)
Lifelong: OAC
|
|
High (CHA2DS2-VASC ≥2) |
ACS |
4 weeks: triple therapy of OAC + aspirin 75-100 mg/day + clopidogrel 75 mg/dayd
Up to 12th month: OAC and clopidogrel 75 mg/day (or alternatively, aspirin 75-100 mg/day)
Lifelong: OAC
|