Understanding and Using the CHADS2 Index

As the population ages, the incidence of atrial fibrillation (AF) and subsequent stroke are expected to more than double. Thromboprophylaxis with warfarin is the gold standard, but treatment entails frequent monitoring, dose adjustments, and stopping and restarting for any type of invasive procedures. Warfarin also confers the risk of hemorrhage that seems to be a contributing factor in its underuse. CHADS2 (Congestive Heart Failure, Hypertension, Age, Diabetes, Stroke) is an evidence-based instrument that can identify thromboembolism risk and guide interventions to prevent stroke by prescribing the correct dose of warfarin. Clinicians need continued education of appropriate anticoagulation in AF patients.