CHA₂DS₂-VA, thromboembolic risk in atrial fibrillation
The ESC 2024 version without the sex category: maximum 8 points. Anticoagulation is recommended from 2 points.
Updated · Methodology
ESC 2024 version. The scale has no sex category: the maximum is 8 points, not 9.
About this calculator
The 2024 ESC atrial fibrillation guidelines replaced CHA2DS2-VASc with CHA2DS2-VA by removing the sex category. The reasoning is that female sex acts as a risk modifier rather than an independent factor, and the threshold for anticoagulation does not depend on sex. A further argument named in the guideline text concerns people not described by a binary sex category. The remaining components are unchanged: heart failure 1 point, hypertension 1, age 65-74 one point and 75 or older two points, diabetes 1, stroke or TIA 2, vascular disease 1. The maximum is now 8 instead of 9. The threshold is unchanged: from 2 points anticoagulation is indicated, at 1 point the decision is individual. Worth keeping in mind: the score describes thromboembolic risk, not treatment benefit, and says nothing about which agent to choose. Bleeding risk is assessed separately, and a high HAS-BLED does not cancel anticoagulation but points at modifiable factors. The scale does not apply to atrial fibrillation with moderate or severe mitral stenosis or a mechanical valve prosthesis, where the valve lesion itself determines the indication for warfarin.
Source
Formula version: esc-2024-v1
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