In a large primary care data set, the CHA(2)DS(2)-VASc score leads to an almost universal recommendation for anticoagulation treatment in those aged >= 65 years with atrial fibrillation

From 2012 to 2016, the oral anticoagulant (OAC) treatment determination for atrial fibrillation (AF) patients moved from the CHADS(2) score to the CHA(2)DS(2)-VASc score. A data set collated during previous studies (2011-19) with de-identified data extracted from clinical records at a single time-point for active adult patients (n= 285 635; 8294 with AF) attending 164 general practices in Australia was analysed. The CHA(2)DS(2)-VASc threshold (score >= 2 men/>= 3 women) captured a significantly higher proportion than CHADS(2)>= 2 (all ages: 85 vs. 68%, P< 0.0001; >= 65 years: 96 vs. 76%, P< 0.0001). The change from CHADS(2) to CHA(2)DS(2)-VASc resulted in a significantly higher proportion of AF patients being recommended OAC, driven by the revised scoring for age.