The CHA2DS2VASc and HAS-BLED scores are practical and guideline-recommended tools for assessing stroke and bleeding risk to guide oral anticoagulation in patients with atrial fibrillation.
Supports guideline-directed use of CHA2DS2-VASc and HAS-BLED in AF; leaves open need for updated validation in contemporary cohorts.
Atrial fibrillation (AF) is associated with an increased risk of stroke compared with the general population. AF-related stroke confers a higher mortality and morbidity risk, and thus, early detection and assessment for the initiation of effective stroke prevention with oral anticoagulation are crucial. Simple and practical risk assessment tools are essential to facilitate stroke and bleeding risk assessment in busy clinics and wards to aid decision making. At present, the CHA2DS2VASc score is recommended by guidelines as the most simple and practical method of assessing stroke risk in AF patients. Alongside this, the use of the HAS-BLED score aims to identify patients at high risk of bleeding for more regular review and follow-up, and draws attention to potentially reversible bleeding risk factors. The aim of this review article is to summarize the current risk scores available for both stroke and bleeding in AF patients, and the recommendations for their use.
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Shahid et al. (2017) studied this question.
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