CHA2DS2-VAS Flashcards
What does CHA2DS2-VAS stand for and how many points for each
1 congestive heart failure
1 hypertension
2 age 75 and over
1 diabetes
2 stroke/ TIA history
1 vascular disease
1 Age 65-74
1 sex being female
What is a CHADSVAS score for?
Risk of stroke with atrial fibrillation
What 5 medical conditions are related to CHA2DS2-VAS
congestive heart failure
hypertension
diabets
vascular disease
stroke/ tia history
What is considered a low, a moderate and a high score in CHA2DS2-VAS
0 for male/ 1 for female= low risk
1 for male= moderate risk
2 + = high risk
what is a the management for low CHA2DS2-VAS
score (0 for male/ 1 for female)
general lifestyle changes
what is a the management for moderate CHA2DS2-VAS score (1 for males)
CONSIDER oral anticoagulants eg warfarin/ DOACS
what is a the management for high CHA2DS2-VAS score (2+ for males/ females)
warfarin or DOAC
example of vitamin K antagonist and what is the percentage defined as well controlled
warfarin
more than 70% of time, it is within therapeutic range
example of non vitamin K oral anticoagulant
DOAC
apixiban/ riveroxiban
What is the management for those already on anticoagulants? (risk factors 4, those on warfarin 1 and those on apixiban 1)
risk factors: control hypertension, control alcohol consumption, being on NSAIDs/ aspirin, control HAS-BLED score (HANAH)
warfarin: assess anticoagulant control
apixiban: monitor the drug
what does the HAS-BLED score stand for
hypertension, abnormal liver/ renal function, stroke, bleeding, labile (unstable) INR, elderly over 65, drugs/ alcohol
what is general lifestyle advice for CHADSVASC 4
avoid alcohol
smoking cessation
healthy diet
exercise
warfarin diasadvatanges 5
increased bleeding risk
can interfere with other medication
control of diet
reversible with vit K
teratogenic
how is warfarin monitored and what is the target range
daily INR
2-3
DOAC disadvantages 5
increased bleeding risk
expensive
contraindicated with renal impairment and history of GI bleed
non reversible
