Interpretation
| Result | Meaning |
|---|---|
| Age ≥ 65 | OAC |
| Age < 65 with CHF, HTN, DM or stroke/TIA | OAC |
| None of the above, but CAD or PAD | Antiplatelet (ASA) |
| None | No antithrombotic |
Formula
Step 1: age ≥ 65 → OAC · Step 2: any of CHF, hypertension, diabetes, prior stroke/TIA → OAC · Step 3: CAD or PAD → antiplatelet · otherwise no antithrombotic
Clinical pearls
- Female sex alone does not trigger anticoagulation under the CCS algorithm.
- Patients with CAD/PAD who meet OAC criteria generally get an OAC alone once beyond the acute/stent period; follow CCS antithrombotic guidance for combinations.
- Not for AF with mechanical valves or moderate–severe mitral stenosis, which need warfarin regardless.
Examples
chads-65 for 58M with hypertension and afccs algorithm 52 year old woman with af and prior stent, no other risk factorsshould a 67 year old with af and no other conditions be anticoagulated
FAQ
What is the CHADS-65 rule?
In Canadian guidelines, anyone with AF aged 65 or older, or with any CHADS₂ risk factor (CHF, hypertension, diabetes, stroke/TIA), should receive oral anticoagulation.
How does CHADS-65 differ from CHA₂DS₂-VASc?
CHADS-65 is a simpler yes/no pathway; it ignores female sex and treats age ≥65 alone as an indication for anticoagulation.