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Recent Journal Updates

JAMAJun 2, 2026
Intra-arterial Alteplase After Thrombectomy for Acute Ischemic Stroke

Clinical Context

We think this might be relevant to the clinical guidance for CHA₂DS₂-VASc Score for Atrial Fibrillation Stroke Risk.

JAMAJun 2, 2026
Intravenous Tenecteplase Prior to Endovascular Treatment for Ischemic Stroke

Clinical Context

We think this might be relevant to the clinical guidance for CHA₂DS₂-VASc Score for Atrial Fibrillation Stroke Risk.

JAMAJun 2, 2026
Intravenous Tenecteplase Prior to Endovascular Treatment for Ischemic Stroke at 4.5 to 24 Hours Research Summary

Clinical Context

We think this might be relevant to the clinical guidance for CHA₂DS₂-VASc Score for Atrial Fibrillation Stroke Risk.

CHA2DS2-VASc

Cardiovascular Decision Support

Risk Profile Indicators

Live Score: 0

Analysis Pending

Select the patient's cardiovascular and clinical risk factors to estimate annual stroke risk and view formal guidelines.

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

When to Use

Assessment of thromboembolic stroke risk in adults with non-valvular atrial fibrillation (paroxysmal, persistent, or permanent).
Decision support for initiating or withholding oral anticoagulation (OAC) therapy.
Identifying "truly low-risk" patients (Score 0 in males, Score 1 in females) who derive no net benefit from OAC.
Recalculation at each clinical encounter, as newly acquired risk factors change management.

Endorsed By

Recommended by the ESC 2020 AF Guidelines (Class I, Level A), the 2023 ACC/AHA/ACCP/HRS AF Guideline, and the European Heart Rhythm Association (EHRA). It is the global standard for AF stroke stratification.

When NOT to Use

Valvular AF (moderate-to-severe mitral stenosis or mechanical heart valve): These patients require warfarin (target INR 2–3 or 2.5–3.5) regardless of score — DOACs are contraindicated.
Hypertrophic Cardiomyopathy (HCM): HCM-related AF carries high inherent stroke risk; anticoagulate without scoring.
Cardiac Amyloidosis with AF: Consider anticoagulation even at low scores — CHA₂DS₂-VASc may underestimate risk.
Pregnancy: Anticoagulant choice (LMWH preferred) is independent of this score.

Definition of "Non-Valvular" AF

The ESC 2020 guideline redefines "non-valvular" to exclude only moderate-to-severe rheumatic mitral stenosis and prosthetic mechanical heart valves. Bioprosthetic valves, mitral valve repair, aortic stenosis, and mitral regurgitation do NOT exclude a patient from CHA₂DS₂-VASc stratification and DOAC use.

Related Scores in Practice

In clinical practice, this assessment is frequently evaluated alongside other validated measures. Depending on the patient's presentation and specific diagnostic requirements, you may also need to utilize the HAS-BLED, ORBIT Score, ABC-AF Stroke Score, ABC-AF Bleeding Score, HEMORR2HAGES, CHADS2, Creatinine Clearance Multi-Method, eGFR (CKD-EPI) or the EHRA Score to formulate a comprehensive care plan.

Last Comprehensive Review: 2026

Related Cardiovascular Tools

HAS-BLED
ORBIT Score
ABC-AF Stroke Score
ABC-AF Bleeding Score
HEMORR2HAGES
CHADS2
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EHRA Score
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