CHA2DS2-VA Score 1 Management — EECC MCQ
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Correct answer: C — Oral anticoagulation should be considered (Class IIa) for CHA₂DS₂-VA score of 1, evaluating the individual risk-benefit ratio
The 2024 ESC AF Guidelines provide the following OAC recommendations based on CHA₂DS₂-VA score: Score 0 = OAC not recommended (Class III); Score 1 = OAC should be considered (Class IIa); Score ≥2 = OAC is recommended (Class I). For a CHA₂DS₂-VA of 1, the decision is individualised, weighing the stroke risk (approximately 1-2%/year) against the bleeding risk. Factors that may tip the balance toward anticoagulation include: the specific risk factor involved (age 65-74 and diabetes carry higher stroke risk than isolated hypertension or vascular disease), patient preference, and the availability of DOACs (which have lower ICH risk than warfarin). Antiplatelet therapy alone is not recommended for stroke prevention in AF.
Reference: ESC (2024): Guidelines for the Management of Atrial Fibrillation