Heart Health

Stroke risk below the anticoagulation threshold

CHA2DS2-VASc — untreated stroke risk above ~2% a year? No

Recommendationaf-anticoag-not-indicatedNo one has reached this rule yet

No routine anticoagulation; reassess at least annually

Clinical review

All reviewers

No clinician has signed off this rule yet. It reflects our reading of the guidelines cited below, which has not been independently checked.

What someone who reaches this rule is told

Word for word, as generated for the example person below. Figures in the text are theirs.

  • Strongly recommended

    Your stroke risk score is 0, which is below the level where a blood thinner is routinely recommended.

    Scored as: no additional risk factors. That corresponds to roughly about 0.2% a year untreated, where the bleeding risk of anticoagulation broadly cancels the benefit. This is worth rechecking whenever something changes — the score climbs with a birthday, and turning 65 or developing high blood pressure or diabetes can move you across the line without anything about the AF itself changing.

    Guideline consensusRecommended by the guideline writing committee, drawing on trials plus expert judgement where trials run out.· Class I· checked 2026-09-12

    2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation · Class I — reassess at least annually

An example person who reaches it

Atrial fibrillation, low stroke score” — an illustrative profile, not a real user.

52-year-old manBP 124/78LDL 120atrial fibrillation, diagnosed10-yr PREVENT-ASCVD 2.2%

Their path through atrial fibrillation

  1. Atrial fibrillation?Yes
  2. How was it found? (the evidence differs)Clinically diagnosed
  3. CHA2DS2-VASc — untreated stroke risk above ~2% a year?No ← this rule
  4. Applies whatever the scoreAlways
  5. Applies whatever the scoreAlways
  6. Applies whatever the scoreAlways

Where it sits

Asked after: Atrial fibrillation

Sources

Cited by the recommendations above.

Review this rule

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Runs in lib/engine/afPathway.ts as af-anticoag-not-indicated.