GARFIELD-AF Risk Score for Atrial Fibrillation
Risk model from the Global Anticoagulant Registry in the FIELD-AF study. Predicts 1-year risk of stroke/SE, major bleeding, and all-cause mortality in newly diagnosed non-valvular AF. Adds smoking and renal function to traditional CHA2DS2-VASc variables.
Score interpretation
Low GARFIELD-AF score — lower 1-year event risk
→ CHA2DS2-VASc guided anticoagulation; if score under 2 (men) or under 3 (women): anticoagulation not routinely recommended; lifestyle modification; rate control if symptomatic; annual reassessment
Moderate score — significant thromboembolic risk
→ DOAC initiation (per NICE NG196); HAS-BLED assessment; modify reversible bleeding risks; rate or rhythm control strategy; risk factor modification; annual review
High GARFIELD-AF score — high 1-year stroke and mortality risk
→ Initiate DOAC urgently; prior stroke: start 2 to 14 days post-event depending on infarct size; if DOAC contraindicated: warfarin INR 2 to 3; BP control; diabetes optimisation; smoking cessation; cardiology or stroke specialist input; LAA occlusion if DOAC long-term contraindicated
Interpretation bands for the GARFIELD-AF. Apply clinical judgement and local guidance.
References
- Fox KAA et al. GARFIELD-AF tool for the assessment of stroke and bleeding in patients with atrial fibrillation: validation in a nationwide AF cohort. BMJ Open. 2016;6(12):e012697.
Related
Curated clinical cross-links plus same-class fallbacks.
- CHA₂DS₂-VASc Score · Atrial Fibrillation
- ORBIT Bleeding Risk Score for AF · Atrial Fibrillation
- CHA₂DS₂-VA Score for AF (2023) · Atrial Fibrillation
- CHADS-65 for Atrial Fibrillation · Atrial Fibrillation
- CHADS-65 Score for Atrial Fibrillation · Atrial Fibrillation
- CHARGE-AF Score for Incident Atrial Fibrillation · Atrial Fibrillation
- Edoxaban (AF Stroke Prevention / VTE) · Direct Factor Xa Inhibitor (DOAC)
- Bivalirudin (PCI Anticoagulation) · Direct Thrombin Inhibitor / PCI
- Vernakalant · Atrial-selective antiarrhythmic
- Aspirin (Loading Dose) · Antiplatelet — ACS / Ischaemic Stroke
- Alteplase (tPA) · Thrombolytic — Ischaemic Stroke / Massive PE
- Bivalirudin · Anticoagulation
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.