This Figure, created for this special publication of The American Journal of Medicine, illustrates in flow-chart form how the scoring system of CHA2DS2-VASc might be used:
- For a score 2–6 on the simpler CHADS2 scoring system, the patient should be anticoagulated, without question; Importantly, this does not mean antiplatelet therapy with aspirin; it means use of an anticoagulant, whether that is warfarin or one of the newer Factor XA or direct thrombin inhibitors.
- For a CHADS2 score of 1 or 0, the physician calculate the CHA2DS2-VASc score. For a CHA2DS2-VASc score of 2, the patient should be anticoagulated; for a CHA2DS2-VASc score of 1, it is up to the physician’s professional discretion.
- Once the better low-risk calculating CHA2DS2-VASc score is 0, it is possible to use aspirin – or nothing.
This novel flow chart takes into consideration careful review of the data from the prior studies presented in the preceding discussion.
Reiffel JA. Am J Med 2013; 126: 00-00.
