🫀 AF Anticoagulation Decision (CHA₂DS₂-VASc + HAS-BLED)
UseSupport the anticoagulation decision in non-valvular AF, including drug preference and bleeding-risk manageme…
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SourceVan Gelder IC, et al. 2024 ESC Guidelines for the management of atrial fibrillation. Eur Heart J 20…
Runs locally in your browser (no PHI uploaded). For licensed clinicians — not a substitute for clinical judgement.
Stored on this device for revisit reminders
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
- Who it is for
- Nonvalvular atrial fibrillation when deciding oral anticoagulation and the next step after bleeding.
- Who it is not for
- Valvular atrial fibrillation and mechanical valves do not use this card. Unrelated to PERC.
- Formula and variables
- Stroke risk uses CHA₂DS₂-VASc: heart failure, hypertension, age ≥75 (2), diabetes, prior stroke/TIA/embolism (2), vascular disease, age 65–74 and female sex, 1 point each. The 2024 ESC guideline uses CHA₂DS₂-VA without the sex item (≥2 recommend, 1 consider OAC); the 2023 ACC/AHA guideline still uses CHA₂DS₂-VASc (men ≥2, women ≥3). The 2023 China AF guideline uses CHA₂DS₂-VASc-60 (age 60–64 = 1, ≥65 = 2; OAC for men ≥2, women ≥3). This page scores the original CHA₂DS₂-VASc. Bleeding risk uses HAS-BLED.
- Result → next step
- Anticoagulation decisions open the atrial-fibrillation anticoagulation page: anticoagulate, hold for now, or individualize. A high bleeding score means fix reversible factors first; do not stop anticoagulation automatically. Bleeding opens the reversal page. No numeric reversal dose.Anticoagulant reversal →
- Guideline
- China atrial fibrillation guideline 2023
Scene next step
📋AF anticoagulationOpen scene pack →Related scores
Matching pathway
🧭af_anticoagOpen pathway →Score + version; reference only — not a substitute for care · no HIS write
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Methodology · worked example, guidelines & full notes
Clinical takeaway
Anticoagulate when the non-sex CHA₂DS₂-VASc score is ≥ 2 (Class I); consider it at 1.
When to use
Support the anticoagulation decision in non-valvular AF, including drug preference and bleeding-risk management.
How it works
CHA₂DS₂-VASc (CHF, hypertension, age ≥ 75 [2], diabetes, prior stroke/TIA [2], vascular disease, age 65–74, female) vs HAS-BLED (uncontrolled BP, abnormal renal/liver function, stroke, bleeding, labile INR, age > 65, drugs/alcohol).
Key points
- Anticoagulate when the non-sex CHA₂DS₂-VASc score is ≥ 2 (Class I); consider it at 1.
- Prefer a DOAC over warfarin in non-valvular AF (Class I).
- A mechanical valve or moderate-severe mitral stenosis contraindicates DOACs — use warfarin.
- A high HAS-BLED score flags modifiable factors to correct — it is not by itself a contraindication to anticoagulation.
References
- [Guideline / primary source]Van Gelder IC, et al. 2024 ESC Guidelines for the management of atrial fibrillation. Eur Heart J 2024
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Age | 70 yr |
|---|---|
| Sex | Male |
| CHF / LV dysfunction | Yes |
| Hypertension (history) | Yes |
| Diabetes | Yes |
| Prior stroke / TIA / thromboembolism | Yes |
| Vascular disease (MI / PAD / aortic plaque) | Yes |
| Uncontrolled hypertension (SBP > 160) | Yes |
| Abnormal renal function (dialysis / transplant / Cr > 200 µmol/L) | Yes |
| Abnormal liver function (chronic liver disease / bilirubin > 2× or transaminase > 3×) | Yes |
| Bleeding history or predisposition | Yes |
| Labile INR (on warfarin) | Yes |
| Concomitant antiplatelet / NSAID | Yes |
| Alcohol excess (≥ 8 units/week) | Yes |
| Mechanical valve OR moderate-severe mitral stenosis | Yes |
→Anticoagulation decisionAnticoagulate
- CHA₂DS₂-VASc：7 points
- HAS-BLED：9 points (high)
- Recommendation class：I
| Age | 70 yr |
|---|---|
| Sex | Female |
| CHF / LV dysfunction | No |
| Hypertension (history) | No |
| Diabetes | No |
| Prior stroke / TIA / thromboembolism | No |
| Vascular disease (MI / PAD / aortic plaque) | No |
| Uncontrolled hypertension (SBP > 160) | No |
| Abnormal renal function (dialysis / transplant / Cr > 200 µmol/L) | No |
| Abnormal liver function (chronic liver disease / bilirubin > 2× or transaminase > 3×) | No |
| Bleeding history or predisposition | No |
| Labile INR (on warfarin) | No |
| Concomitant antiplatelet / NSAID | No |
| Alcohol excess (≥ 8 units/week) | No |
| Mechanical valve OR moderate-severe mitral stenosis | No |
→Anticoagulation decisionConsider anticoagulation
- CHA₂DS₂-VASc：2 points
- HAS-BLED：1 points (low)
- Recommendation class：IIa
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using AF Anticoagulation Decision (CHA₂DS₂-VASc + HAS-BLED)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does AF Anticoagulation Decision (CHA₂DS₂-VASc + HAS-BLED) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is AF Anticoagulation Decision (CHA₂DS₂-VASc + HAS-BLED) calculated in practice? Can you show a worked example?
- Inputs: Age 70 yr, Sex Male, CHF / LV dysfunction Yes, Hypertension (history) Yes, Diabetes Yes, Prior stroke / TIA / thromboembolism Yes, Vascular disease (MI / PAD / aortic plaque) Yes, Uncontrolled hypertension (SBP > 160) Yes… → Result: Anticoagulation decision Anticoagulate（CHA₂DS₂-VASc: 7 points, HAS-BLED: 9 points (high), Recommendation class: I） Inputs: Age 70 yr, Sex Female, CHF / LV dysfunction No, Hypertension (history) No, Diabetes No, Prior stroke / TIA / thromboembolism No, Vascular disease (MI / PAD / aortic plaque) No, Uncontrolled hypertension (SBP > 160) No… → Result: Anticoagulation decision Consider anticoagulation（CHA₂DS₂-VASc: 2 points, HAS-BLED: 1 points (low), Recommendation class: IIa）