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🫀 AF Anticoagulation Decision (CHA₂DS₂-VASc + HAS-BLED)

Decide on anticoagulation in non-valvular atrial fibrillation by combining stroke risk (CHA₂DS₂-VASc) and bleeding risk (HAS-BLED). Instant, browser-side.

AF Anticoagulation Decision (CHA₂DS₂-VASc + HAS-BLED)

Age (yr)
Sex
CHF / LV dysfunction
Hypertension (history)
Diabetes
Prior stroke / TIA / thromboembolism
Vascular disease (MI / PAD / aortic plaque)
Uncontrolled hypertension (SBP > 160)
Abnormal renal function (dialysis / transplant / Cr > 200 µmol/L)
Abnormal liver function (chronic liver disease / bilirubin > 2× or transaminase > 3×)
Bleeding history or predisposition
Labile INR (on warfarin)
Concomitant antiplatelet / NSAID
Alcohol excess (≥ 8 units/week)
Mechanical valve OR moderate-severe mitral stenosis

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

Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.

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