Does a CHA₂DS₂-VASc score of 3 need blood thinners for AFib?

Question

Hello doctor,

I have been living with atrial fibrillation (AFib) for about a year now, and even though I have managed it through medication, I continue to be very nervous when my heart starts misbehaving.

My last visit to a cardiology specialist ended with my CHA₂DS₂-VASc score being 3. While my doctor explained that it raises my chances of having a stroke, I did not thoroughly understand what it means.

Is there a way to know whether my case of AFib makes me prone to a stroke when I am 58 years old?
Am I supposed to take an anticoagulant drug because of a score of 3?
Do I need to think of something else?

Kindly help.

Answer 1

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern.

The link between stroke and AFib occurs because of the arrhythmia of the heartbeat, which makes it possible for the blood to clot in areas like the left atrial appendage due to blood pooling. The blood clot could move into the brain and cause a stroke.

The decision to start a blood thinner is based on your overall stroke risk, not on your age alone. The CHA₂DS₂-VASc score is the standard tool used to estimate that risk. If your score is truly 3, current guidelines generally recommend long-term anticoagulation (blood-thinning medication), unless there is a medical reason not to use it.

Medications such as Apixaban, Rivaroxaban, Dabigatran, or Edoxaban are commonly prescribed because, for most people with a score of 3, the benefit of reducing stroke risk outweighs the risk of bleeding.

Also, there is a possibility of some discrepancy with the information you have shared. I understood from your question that you are 58 years old, but the message also mentions 43 years old. It is relevant since one of the variables used for the calculation of the CHA₂DS₂-VASc score is age.

I suggest checking your score with your cardiologist to confirm it. Keep on taking your anticoagulation medicines for atrial fibrillation, and make sure that all other risk factors for having a stroke (hypertension, diabetes, and smoking) are controlled if you have them.

Seek medical help immediately in case you have symptoms of a stroke (one-sided weakness or numbness, difficulty talking, changes in vision, dizziness, or inability to balance).

If you do not understand why your CHA₂DS₂-VASc score is 3, I would recommend that you consult your cardiologist and ask him/her how this score was determined.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.