In a large primary care data set, the CHA2DS2-VASc score leads to an almost universal recommendation for anticoagulation treatment in those aged ≥65 years with atrial fibrillation


From 2012 to 2016, the oral anticoagulant (OAC) treatment determination for atrial fibrillation (AF) patients moved from the CHADS2 score to the CHA2DS2-VASc score. A data set collated during previous studies (2011–19) with de-identified data extracted from clinical records at a single timepoint for active adult patients (n=285 635; 8294 with AF) attending 164 general practices in Australia was analysed. The CHA2DS2-VASc threshold (score ≥2 men/≥3 women) captured a significantly higher proportion than CHADS2≥2 (all ages: 85 vs. 68%, P<0.0001; ≥65 years: 96 vs. 76%, P< 0.0001). The change from CHADS2 to CHA2DS2-VASc resulted in a significantly higher proportion of AF patients being recommended OAC, driven by the revised scoring for age.


stroke prevention, general practice, atrial fibrillation

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