Stroke & Bleeding risk assessment Part 2

What are the learning outcomes of the CHA2DS2-VASc lecture? (3 points

1. Describe the components of the CHA2DS2-VASc risk assessment tool

2. Be confident calculating a CHA2DS2-VASc score and understanding its significance

3. Be confident explaining stroke risk to a patient based on the score

What is the CHA2DS2-VASc score and what does it assess? (4 points)

. A tool to estimate the 12-month stroke risk for patients with atrial fibrillation (AF)

2. Supports clinical decisions on anticoagulation therapy

3. Each letter corresponds to an independent stroke risk factor

4. Higher scores indicate higher stroke risk

What are the components of the CHA2DS2-VASc score? (8 points)

1. C - Congestive heart failure = 1 point

2. H - Hypertension = 1 point

3. A2 - Age -75 = 2 points

4. D - Diabetes mellitus = 1 point

5. S2 - Stroke/TIA/thromboembolism = 2 points

6. V - Vascular disease = 1 point

7. A - Age 65-74 = 1 point

8. Sc - Sex category (female) = 1 point

How is the CHA2DS2-VASc score calculated using a case example? (7 points)

1. Mr Brown: 68-year-old male

2. Has type 2 diabetes mellitus (+1)

3. Has hypertension (+1)

4. Age 65-74 (+1)

5. No congestive heart failure (+0)

6. No stroke/TIA or thromboembolism (+0)

7. No vascular disease, male gender (+0); Total score = 3

What are the clinical consequences of the CHA2DS2-VASc score? (4 points)

1. Score predicts the annual stroke risk

2. Higher score = greater benefit from anticoagulation

3. Do not offer anticoagulation for men <65 with no risk factors

4. Offer anticoagulation to those with a score -2

Q: What is NICE guidance on anticoagulation based on CHA2DS2-VASc score? (3 points)

1. Do not offer stroke prevention to those <65 with AF and no other risk factors

2. Consider anticoagulation for men with score of 1 (not women)

3. Offer anticoagulation to patients with score of 2 or mor

Q: What is the pharmacist's role in communicating stroke risk to patients? (2 points)

1. Ensure patients understand the risk associated with their CHA2DS2-VASc score

2. Support informed decisions about anticoagulation therapy