🫀 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.
Clinical takeaway
Anticoagulate when the non-sex CHA₂DS₂-VASc score is ≥ 2 (Class I); consider it at 1.
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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.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Age | 70 yr |
|---|---|
| Sex | Male |
| CHF / LV dysfunction | Yes |
| Hypertension (history) | Yes |
| Diabetes | Yes |
| Prior stroke / TIA / thromboembolism | Yes |
| Vascular disease (MI / PAD / aortic plaque) | Yes |
| Uncontrolled hypertension (SBP > 160) | Yes |
| Abnormal renal function (dialysis / transplant / Cr > 200 µmol/L) | Yes |
| Abnormal liver function (chronic liver disease / bilirubin > 2× or transaminase > 3×) | Yes |
| Bleeding history or predisposition | Yes |
| Labile INR (on warfarin) | Yes |
| Concomitant antiplatelet / NSAID | Yes |
| Alcohol excess (≥ 8 units/week) | Yes |
| Mechanical valve OR moderate-severe mitral stenosis | Yes |
→Anticoagulation decisionAnticoagulate
- CHA₂DS₂-VASc：7 points
- HAS-BLED：9 points (high)
- Recommendation class：I
| Age | 70 yr |
|---|---|
| Sex | Female |
| CHF / LV dysfunction | No |
| Hypertension (history) | No |
| Diabetes | No |
| Prior stroke / TIA / thromboembolism | No |
| Vascular disease (MI / PAD / aortic plaque) | No |
| Uncontrolled hypertension (SBP > 160) | No |
| Abnormal renal function (dialysis / transplant / Cr > 200 µmol/L) | No |
| Abnormal liver function (chronic liver disease / bilirubin > 2× or transaminase > 3×) | No |
| Bleeding history or predisposition | No |
| Labile INR (on warfarin) | No |
| Concomitant antiplatelet / NSAID | No |
| Alcohol excess (≥ 8 units/week) | No |
| Mechanical valve OR moderate-severe mitral stenosis | No |
→Anticoagulation decisionConsider anticoagulation
- CHA₂DS₂-VASc：2 points
- HAS-BLED：1 points (low)
- Recommendation class：IIa
Frequently asked questions
- What is 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.
- How is AF Anticoagulation Decision (CHA₂DS₂-VASc + HAS-BLED) calculated? What is the core formula?
- 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).
- When is AF Anticoagulation Decision (CHA₂DS₂-VASc + HAS-BLED) used?
- Support the anticoagulation decision in non-valvular AF, including drug preference and bleeding-risk management.
- What are the key clinical points for AF Anticoagulation Decision (CHA₂DS₂-VASc + HAS-BLED)?
- 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.
- What are the limits and cautions when using AF Anticoagulation Decision (CHA₂DS₂-VASc + HAS-BLED)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is AF Anticoagulation Decision (CHA₂DS₂-VASc + HAS-BLED) calculated in practice? Can you show a worked example?
- Inputs: Age 70 yr, Sex Male, CHF / LV dysfunction Yes, Hypertension (history) Yes, Diabetes Yes, Prior stroke / TIA / thromboembolism Yes, Vascular disease (MI / PAD / aortic plaque) Yes, Uncontrolled hypertension (SBP > 160) Yes… → Result: Anticoagulation decision Anticoagulate（CHA₂DS₂-VASc: 7 points, HAS-BLED: 9 points (high), Recommendation class: I） Inputs: Age 70 yr, Sex Female, CHF / LV dysfunction No, Hypertension (history) No, Diabetes No, Prior stroke / TIA / thromboembolism No, Vascular disease (MI / PAD / aortic plaque) No, Uncontrolled hypertension (SBP > 160) No… → Result: Anticoagulation decision Consider anticoagulation（CHA₂DS₂-VASc: 2 points, HAS-BLED: 1 points (low), Recommendation class: IIa）