The HAS-BLED score ( Table 2) 5 has been developed to determine the risk of bleeding. It is better at identifying ‘truly low-risk’ patients with atrial fibrillation, and is now preferred over CHADS 2. The CHA 2DS 2-VASc score ( Table 2), 5 introduced by the European Society of Cardiology, provides a more comprehensive assessment of the risk factors for stroke. 4 Anticoagulation with warfarin is recommended if the CHADS 2 score is ≥2 and should be considered if the score is 1. The CHADS 2 score reliably identifies patients at intermediate and high risk of stroke, but less reliably identifies those truly at low risk. This assigns 1 point each for congestive heart failure, hypertension, age 75 years and older, and diabetes mellitus, and 2 points for previous ischaemic stroke or transient ischaemic attack. In patients with non-valvular atrial fibrillation, the decision to start warfarin should be based on the CHADS 2 score.
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