In a large primary care data set, the CHA2DS2-VASc score leads to an almost universal recommendation for anticoagulation treatment in those aged ≥65 years with atrial fibrillation

From 2012-16, the oral anticoagulant (OAC) treatment determination for atrial fibrillation (AF) patients moved from the CHADS₂ to the CHA₂DS₂-VASc score. A dataset collated during previous studies (2011-2019) with deidentified data extracted from clinical records at a single-timepoint for active adult patients (n=285,635; 8,294 with AF) attending 164 general practices in Australia was analysed. The CHA₂DS₂-VASc threshold (score ≥2 men/≥3 women) captured a significantly higher proportion than CHADS₂≥2 (all ages: 85% vs 68%, p<0.0001; ≥65 years: 96% vs 76%, p<0.0001). The change from CHADS₂ to CHA₂DS₂-VASc resulted in a significantly higher proportion of AF patients being recommended OAC, driven by the revised scoring for age.