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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

Orchard, Jessica J.; Giskes, Katrina; Orchard, John W.; La Gerche, Andre; Neubeck, Lis; Hespe, Charlotte; Lowres, Nicole; Freedman, Ben


Jessica J. Orchard

Katrina Giskes

John W. Orchard

Andre La Gerche

Charlotte Hespe

Nicole Lowres

Ben Freedman


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.

Journal Article Type Article
Acceptance Date Dec 31, 2022
Online Publication Date Jan 3, 2023
Publication Date 2023-11
Deposit Date Jan 9, 2023
Publicly Available Date Jan 9, 2023
Print ISSN 1474-5151
Electronic ISSN 1873-1953
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 22
Issue 8
Pages 769–772
Keywords stroke prevention, general practice, atrial fibrillation
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