Risk stratification of patients with atrial fibrillation: Biomarkers and other future perspectives

Table 1 Explaining the CHADS₂ and CHA₂DS₂-VASc risk scores

Risk score	Risk factor	Risk score	Risk factor
C	Congestive heart failure	C	Congestive heart failure (or left ventricular systolic dysfunction)
H	Hypertension	H	Hypertension
A	Age ≥ 75 yr	A2	Age 65 to 74 yr
			Age ≥ 75 yr1
D	Diabetes mellitus	D	Diabetes mellitus
S2	Stroke or transient ischemic attack1	S2	Stroke or transient ischemic attack1
		VASc	Previous myocardial infarction, peripheral arterial disease or aortic plaque
			Female

All variables are assigned one point, when present, except those marked with (¹), which receive two points. Subjects with a CHADS₂ score of 0 (low risk) should be placed under antiplatelet therapy, those with a score of 1 (intermediate risk) can either undergo oral anticoagulation or antiplatelet therapy and the remaining (high risk) have clear benefit with oral anticoagulation, unless contraindicated. Using the CHA₂DS₂-VASc score, individuals with a score of zero (truly low risk) should be placed under no treatment (preferably) or, as an option, medicated with an antiplatelet agent. Intermediate risk individuals (score of 1) should be placed under oral anticoagulation (preferably) or antiplatelet agents (as an alternative). The remaining patients (score ≥ 2) should be anticoagulated.