CHA2DS2-VASc — untreated stroke risk above ~2% a year? Yes (score >=2 men / >=3 women)
af-anticoag-indicatedNo one has reached this rule yetAnticoagulation recommended; a DOAC preferred over warfarin
No clinician has signed off this rule yet. It reflects our reading of the guidelines cited below, which has not been independently checked.
Word for word, as generated for the example person below. Figures in the text are theirs.
Your stroke risk score is 5, which is in the range where a blood thinner is recommended. This is the single highest-value conversation on this page.
Proven in trialsTrials counted real events, like heart attacks, strokes, or deaths, and this changed them.
Ask a cardiologist about this one. Take this to a cardiologist, not a search engine. Whether to anticoagulate is well founded and worth raising — but the decision in your case turns on things this tool has not asked about, including any history of bleeding, and it is not one to act on from a web page.
Scored as: High blood pressure (1), Age 75 or over (2), Diabetes (1), Female (1). That puts your untreated stroke risk at about 7% a year, and the guideline recommends anticoagulation once that risk passes about 2% a year — which is a score of 2 or more for men and 3 or more for women, because being female shifts risk without being a driver in its own right. Anticoagulation cuts the risk of these strokes by roughly two-thirds, and AF-related strokes are more often fatal or disabling than other strokes.
ACC/AHA (US)
Graded for an estimated stroke risk of 2% a year or more, equivalent to a CHA2DS2-VASc score of 2 or higher in men and 3 or higher in women. At 1% to under 2% a year (1 in men, 2 in women) anticoagulation is reasonable (2a, A).
2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of… · Recommendation behind this rule · class and level read from the guideline tables on 2026-09-30
2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation · Class 1 · Level A
Ask which anticoagulant is right for you — and whether a DOAC or warfarin.
Proven in trialsTrials counted real events, like heart attacks, strokes, or deaths, and this changed them.
We are deliberately not naming a drug class here. For most people a DOAC is preferred over warfarin, but the exceptions are absolute rather than marginal: a mechanical heart valve or moderate-to-severe mitral stenosis means warfarin, not a DOAC. Dose then turns on kidney function, weight, age, bleeding history, and interactions. Those are the questions to take in, and they are worth asking in exactly that order.
ACC/AHA (US)
A DOAC is recommended over warfarin in people without moderate to severe rheumatic mitral stenosis or a mechanical heart valve.
2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of… · Recommendation behind this rule · class and level read from the guideline tables on 2026-09-30
Why this is a question. It would need whether you have a mechanical valve or significant mitral stenosis, your bleeding history. Add those to your numbers and this becomes a direct recommendation.
2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation · Class 1 · Level A
“Atrial fibrillation, blood thinner not yet discussed” — an illustrative profile, not a real user.
Asked after: Atrial fibrillation
Cited by the recommendations above.
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Runs in lib/engine/afPathway.ts as af-anticoag-indicated.