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CHA2DS2VA & HASBLED

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OAC is indicated

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CHA2DS2VA

Congestive heart ailure: HFrEF, HFmrEF, HFpEF, asymptomatic LVEF ≤ 40%
Hypertension: BP>140/90 mmHg)
Age
Diabetes mellitus (type 1 or type 2) or treated with glucose lowering therapy
Prior stroke or TIA or arterial thromboembolism
Vascular disease: CAD, PAD, complex aortic plaque on imaging
Female (Use for calculate risk of stroke per year)

HASBLED

Hypertension: Uncontrolled, SBP >160 mmHg
Abnormal liver function (Cirrhosis or bilirubin >2x normal with AST/ALT/AP >3x normal)
Abnormal renal function (Dialysis, transplant, Cr >2.26 mg/dL or >200 µmol/L)
Stroke history
Prior major bleeding or predisposition to bleeding
Labile INR Unstable/high INRs, time in therapeutic range <60%
Age >65
Medication usage predisposing to bleeding Aspirin, clopidogrel, NSAIDs
Alcohol: ≥ 8 drinks/week

Note: The HASBLED score should be used to identify modifiable risk factors for bleeding.

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References

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​Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. 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. Chest 2010;137:263–272.

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Lip GY, Frison L, Halperin J, Lane D. Identifying patients at risk of stroke despite anticoagulation. Stroke 2010;in press.

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Lip GY, Frison L, Halperin JL, Lane DA. Comparative validation of a novel risk score for predicting bleeding risk in anticoagulated patients with atrial fibrillation: the HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) score. J Am Coll Cardiol. 2011 Jan 11;57(2):173-80. 

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Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip GY. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010 Nov;138(5):1093-100. 

©2023 BY Piti Niyomsirivanich, MD. (Personal website)

 

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We assume no responsibility for how you utilize or interpret or any other information provided on this website.

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