I came across an interesting risk stratification tool for stroke management today and thought I would share on my blog to help others learn more about this field of Clinical Pharmacy.

The CHADS-VASc model has been designed to go some way to assess the stroke risk for those patients with non-valvular atrial fibrillation (AF).

Essentially, the model scores the patient according to their characteristics / previous history. The following provides an indication as to what is considered plus the accompanying score system:

Congestive cardiac failure: 1 Point
Hypertension: 1 Point
Age greater than 75 years: 2 Points
Diabetes mellitus: 1 Point
History of stroke or thrombotic event: 2 Points
History of vascular disease of the arteries: 1 Point
Age ranging from 65 to 74 years: 1 Point
Sex: Female 1 Point

Once added together the overall score indicates the likelihood of thromboembolism for the patient. Those patients with a value greater or equal to 1 should be considered for anticoagulant treatment. Such treatment might be with for example warfarin or a DOAC (e.g. apixaban, rivaroxaban or edoxaban).

Importantly, antiplatelet therapy is not recommended to guard against a thrombotic event and thus should not be prescribed for the patient in question.