How does ATRIA differ from CHA₂DS₂-VASc?

Both predict stroke in AF, but ATRIA uses a weighted point system (maximum 15) and incorporates renal function and proteinuria, which CHA₂DS₂-VASc does not. Studies suggest ATRIA has similar or slightly better discriminatory performance, especially in patients with prior stroke.

What score indicates high stroke risk?

An ATRIA score of 7 to 15 indicates high risk, corresponding to an estimated annual stroke rate of approximately 2.6% or higher. Scores of 0–5 are low risk (~0.5% per year) and a score of 6 is intermediate (~1.0% per year).

Does a low ATRIA score mean no anticoagulation is needed?

A low score suggests lower stroke risk, but clinical judgment is always required. Guidelines recommend discussing risks and benefits of anticoagulation with each patient individually, considering bleeding risk alongside stroke risk.

What is proteinuria for ATRIA scoring?

The original ATRIA cohort defined proteinuria as urine dipstick protein of 1+ or higher; a protein-to-creatinine ratio of 200 mg/g or higher is an equivalent clinical definition. It adds 1 point regardless of prior stroke history.

ATRIA Stroke Score

Enter patient risk factors to calculate the ATRIA stroke risk score and estimated annual stroke rate for atrial fibrillation.

Patient Risk Factors

All fields required. Score updates instantly.

Age (years)

Age carries the highest weight in the ATRIA model.

History of ischemic stroke?

Yes No

Kidney risk factors Proteinuria (urine protein/creatinine ≥ 200 mg/g or dipstick ≥ 1+) eGFR < 45 mL/min/1.73 m² or ESRD

Comorbidities

Female sex Diabetes mellitus Congestive heart failure Hypertension

Fill in the patient factors and click Calculate to see the ATRIA stroke risk score.

Risk Category

out of 15

—

Annual stroke rate: —

Score Breakdown

ATRIA Risk Reference

Score	Risk	Annual Stroke Rate
0 – 5	Low	~0.5%
6	Intermediate	~1.0%
7 – 15	High	~2.6%+

This educational estimate is not a diagnosis and must not be used as the sole basis for anticoagulation or other treatment decisions. Confirm inputs and apply current clinical guidelines with a qualified clinician.

Summary

The ATRIA (AnTicoagulation and Risk factors In Atrial fibrillation) stroke risk score is a validated clinical tool that estimates annual stroke risk in patients with atrial fibrillation. It considers age with prior ischemic stroke history, female sex, diabetes, heart failure, hypertension, proteinuria, and reduced kidney function. Scores of 0–5 indicate low risk, 6 indicates intermediate risk, and 7–15 indicate high risk of ischemic stroke.

How it works

Enter the patient's age and select whether they have a history of ischemic stroke.
Indicate female sex, diabetes mellitus, congestive heart failure, or hypertension.
Indicate proteinuria and eGFR below 45 mL/min/1.73 m² or ESRD regardless of prior stroke history.
The calculator sums the weighted risk factors to produce the ATRIA score (0–15).
The score maps to an estimated annual stroke rate: low (0–5), intermediate (6), or high (7–15) risk category.

Use cases

Stratify stroke risk in newly diagnosed atrial fibrillation patients.
Support anticoagulation therapy decisions in clinical practice.
Compare ATRIA risk category alongside CHADS₂ or CHA₂DS₂-VASc scores.
Screen patients with AF before procedures requiring anticoagulation adjustment.
Educate patients about their individual annual stroke risk percentage.
Document risk stratification in electronic health records.

Frequently Asked Questions

Last updated: 2026-09-30 · Reviewed by Nham Vu