Logo

Klinik Kesihatan Buloh Kasap

ATRIAL FIBRILLATION ASSESSMENT

Calculate CHA₂DS₂-VASc (Stroke Risk) & HAS-BLED (Bleeding Risk).

CHA₂DS₂-VASc Score

Estimates the risk of stroke in patients with non-valvular atrial fibrillation.

Congestive Heart Failure (+1)
Signs/symptoms of heart failure or objective evidence of reduced LVEF.
Hypertension (+1)
Resting blood pressure > 140/90 mmHg on at least 2 occasions or on antihypertensive medication.
Age (+1 or +2)
Diabetes Mellitus (+1)
Fasting blood glucose > 125 mg/dL (7.0 mmol/L) or treatment with oral hypoglycemic agent/insulin.
Stroke / TIA / Thromboembolism (+2)
Previous history of stroke, transient ischemic attack, or thromboembolism.
Vascular Disease (+1)
Prior myocardial infarction, peripheral artery disease, or aortic plaque.
Sex Category (+1)
Female sex is a risk modifier for stroke.

HAS-BLED Score

Estimates 1-year risk for major bleeding in patients with AF.

Hypertension (+1)
Uncontrolled hypertension (Systolic > 160 mmHg).
Abnormal Renal Function (+1)
Chronic dialysis, renal transplantation, or serum creatinine > 200 µmol/L.
Abnormal Liver Function (+1)
Cirrhosis, or Bilirubin > 2x Normal with AST/ALT/ALP > 3x Normal.
Stroke History (+1)
Previous ischemic or hemorrhagic stroke.
Bleeding History or Predisposition (+1)
Prior major bleeding or predisposition to bleeding (e.g., anemia).
Labile INRs (+1)
Unstable/high INRs or poor time in therapeutic range (TTR < 60%) if on VKA.
Elderly (+1)
Age > 65 years.
Drugs Predisposing to Bleeding (+1)
Concomitant use of antiplatelets (e.g., Aspirin) or NSAIDs.
Alcohol Abuse (+1)
Consumption of ≥ 8 drinks per week.
CHA₂DS₂-VASc SCORE

0

/ 9
Low Stroke Risk
0 Points (Male): Anticoagulation generally not recommended.
HAS-BLED SCORE

0

/ 9
Low Bleeding Risk
Low risk. Favorable profile for anticoagulation.

Oral Anticoagulants Quick Reference

Key clinical differences between Non-vitamin K Antagonist Oral Anticoagulants (NOACs/DOACs) and Vitamin K Antagonists (VKAs).

Drug Class Drug Name Standard Dosing Key Clinical Notes Specific Reversal Agent
Vitamin K Antagonist (VKA) Warfarin Once daily
(Target INR 2.0 - 3.0)		 Requires routine INR monitoring. High risk of food (Vitamin K) and drug interactions. Vitamin K (IV/PO)
Prothrombin Complex Concentrate (PCC)
Fresh Frozen Plasma (FFP)
Direct Oral Anticoagulants (DOACs / NOACs) Dabigatran
(Direct Thrombin Inhibitor)		 Twice daily High renal clearance (~80%). Must be kept in original bottle (moisture sensitive). Avoid in severe renal impairment. Idarucizumab (Praxbind)
Rivaroxaban
(Factor Xa Inhibitor)		 Once daily
(With evening meal)		 Must be taken with food to ensure adequate absorption for doses ≥ 15mg. Andexanet alfa (Andexxa)
or 4-factor PCC (off-label)
Apixaban
(Factor Xa Inhibitor)		 Twice daily Dose reduction required if 2 of 3 criteria met: Age ≥ 80, Body Weight ≤ 60kg, Serum Creatinine ≥ 1.5 mg/dL. Generally preferred in renal impairment. Andexanet alfa (Andexxa)
or 4-factor PCC (off-label)
Edoxaban
(Factor Xa Inhibitor)		 Once daily Do NOT use if CrCl > 95 mL/min (due to increased risk of ischemic stroke). Dose reduce for weight ≤ 60kg or specific drug interactions. Andexanet alfa (Andexxa)
or 4-factor PCC (off-label)

JUMPA KAMI DI:

Klinik Kesihatan Buloh Kasap,

Jln Tasik Alai, Buloh Kasap,

Segamat 85000, Johor

Hubungi Kami

Phone: +607 799 1241

Email: kkbulohkasap@gmail.com

Legal Notice