





| 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
|