{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:02:05Z","timestamp":1785423725963,"version":"3.56.0"},"reference-count":12,"publisher":"Akademiai Kiado Zrt.","issue":"21","funder":[{"name":"MedicalScan Kft."}],"content-domain":{"domain":["www.akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2025,5,25]]},"abstract":"<jats:p>\n                    <jats:italic>Bevezet\u00e9s:<\/jats:italic>\n                    A nonvalvularis pitvarfibrill\u00e1ci\u00f3 kezel\u00e9s\u00e9ben egyre\n                    jelent\u0151sebb szerepet j\u00e1tszanak a direkt or\u00e1lis antikoagul\u00e1nsok a\n                    stroke-prevenci\u00f3ban. Kor\u00e1bbi tanulm\u00e1nyok igazolt\u00e1k, hogy a direkt or\u00e1lis\n                    antikoagul\u00e1nsok ter\u00e1piah\u0171s\u00e9ge jobb, mint a K-vitamin-antagonist\u00e1k\u00e9, ugyanakkor\n                    m\u00e9g mindig szuboptim\u00e1lis.\n                    <jats:italic>C\u00e9lkit\u0171z\u00e9s:<\/jats:italic>\n                    A szerz\u0151k c\u00e9lja a direkt\n                    or\u00e1lis antikoagul\u00e1nsok perzisztenci\u00e1j\u00e1nak vizsg\u00e1lata volt pitvarfibrill\u00e1ci\u00f3ban\n                    szenved\u0151kn\u00e9l, a Nemzeti Eg\u00e9szs\u00e9gbiztos\u00edt\u00e1si Alapkezel\u0151 adatb\u00e1zis\u00e1nak\n                    elemz\u00e9s\u00e9vel.\n                    <jats:italic>M\u00f3dszer:<\/jats:italic>\n                    A 2015 \u00e9s 2018 k\u00f6z\u00f6tti id\u0151szakban direkt\n                    or\u00e1lis antikoagul\u00e1ns ter\u00e1pi\u00e1ban r\u00e9szes\u00fcl\u0151 betegek adatait elemezt\u00fck a Nemzeti\n                    Eg\u00e9szs\u00e9gbiztos\u00edt\u00e1si Alapkezel\u0151 adatb\u00e1zis\u00e1nak felhaszn\u00e1l\u00e1s\u00e1val, figyelembe v\u00e9ve\n                    az \u00fajonnan kezelt \u00e9s a m\u00e1r kor\u00e1bban direkt or\u00e1lis antikoagul\u00e1ns ter\u00e1pi\u00e1ban\n                    r\u00e9szes\u00fcl\u0151 csoportokat. A betegek gy\u00f3gyszerkiv\u00e1lt\u00e1sait 14 h\u00f3napon kereszt\u00fcl\n                    k\u00f6vett\u00fck, \u00e9s a perzisztencia v\u00e1ltoz\u00e1sait Kaplan\u2013Meier-anal\u00edzissel \u00e9rt\u00e9kelt\u00fck.\n                    Meghat\u00e1roztuk az egyes hat\u00f3anyagok \u00e1tlagos gy\u00f3gyszerszed\u00e9si idej\u00e9t \u00e9s annak\n                    95%-os konfidenciaintervallum\u00e1t.\n                    <jats:italic>Eredm\u00e9nyek:<\/jats:italic>\n                    Az \u00fajonnan direkt\n                    or\u00e1lis antikoagul\u00e1ns ter\u00e1pi\u00e1t kezd\u0151k egy\u00e9ves perzisztenci\u00e1ja \u00e1tlagosan 63,4%\n                    volt, m\u00edg a m\u00e1r kezelt betegek k\u00f6r\u00e9ben ez 71,1%-nak ad\u00f3dott. A m\u00e1r kezelt\n                    betegek egy\u00e9ves \u00e1tlagos perzisztenci\u00e1ja 7,7 sz\u00e1zal\u00e9kponttal volt nagyobb a\n                    direkt or\u00e1lis antikoagul\u00e1ns ter\u00e1pi\u00e1val \u00fajonnan kezeltekhez k\u00e9pest, amely\n                    hat\u00f3anyagonk\u00e9nt az apixabann\u00e1l +4,9 sz\u00e1zal\u00e9kpont, a dabigatr\u00e1n eset\u00e9ben +9,5\n                    sz\u00e1zal\u00e9kpont, m\u00edg a rivaroxabant szed\u0151kn\u00e9l +9,4 sz\u00e1zal\u00e9kpont el\u0151nyt jelentett.\n                    Az egy\u00e9ves perzisztencia mindk\u00e9t csoportban a 2017-es \u00e9vben volt a legjobb\n                    (65,7%, illetve 72,5%). Az \u00fajonnan kezelt betegekn\u00e9l az \u00e1tlagos perzisztencia\n                    61,5% volt az apixaban, 57,7% a dabigatr\u00e1n \u00e9s 62,9% a rivaroxaban eset\u00e9ben. A\n                    m\u00e1r kor\u00e1bban direkt or\u00e1lis antikoagul\u00e1ns ter\u00e1pi\u00e1ban r\u00e9szes\u00fcl\u0151 betegek \u00e1tlagos\n                    egy\u00e9ves perzisztenci\u00e1ja hat\u00f3anyagokra bontva: apixaban 66,4%, dabigatr\u00e1n 67,4%,\n                    rivaroxaban 72,3%. Az \u00faj betegek eset\u00e9ben a 360 napra korl\u00e1tozott \u00e1tlagos\n                    gy\u00f3gyszerszed\u00e9si id\u0151 299 nap volt, m\u00edg a m\u00e1r kezelt betegek eset\u00e9ben 322 nap.\n                    <jats:italic>K\u00f6vetkeztet\u00e9s:<\/jats:italic>\n                    Az egyes direkt or\u00e1lis antikoagul\u00e1ns\n                    hat\u00f3anyagok k\u00f6z\u00f6tt k\u00fcl\u00f6nbs\u00e9geket tal\u00e1ltunk az egy\u00e9ves perzisztencia\n                    vonatkoz\u00e1s\u00e1ban, ugyanakkor \u00e1ltal\u00e1noss\u00e1gban meg\u00e1llap\u00edthat\u00f3, hogy 2016-t\u00f3l n\u0151tt a\n                    vizsg\u00e1lt direkt or\u00e1lis antikoagul\u00e1ns hat\u00f3anyagok ter\u00e1piah\u0171s\u00e9ge, ugyanakkor\n                    jelent\u0151s er\u0151fesz\u00edt\u00e9seket kell tenni ennek tov\u00e1bbi jav\u00edt\u00e1s\u00e1ra. Orv Hetil. 2025;\n                    166(21): 808\u2013816.\n                  <\/jats:p>","DOI":"10.1556\/650.2025.33286","type":"journal-article","created":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T00:24:25Z","timestamp":1748219065000},"page":"808-816","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":1,"title":["Direkt or\u00e1lis antikoagul\u00e1nssal kezelt pitvarfibrill\u00e1l\u00f3 betegek ter\u00e1piah\u0171s\u00e9g\u00e9nek \u00f6sszehasonl\u00edt\u00e1sa a 2015\u20132018-as \u00e9vek adatai alapj\u00e1n"],"prefix":"10.1556","volume":"166","author":[{"given":"G\u00e1bor","family":"Simonyi","sequence":"first","affiliation":[{"name":"D\u00e9l-budai Centrumk\u00f3rh\u00e1z \u2013 Szent Imre Egyetemi Oktat\u00f3k\u00f3rh\u00e1z, Anyagcsere K\u00f6zpont Budapest, T\u00e9t\u00e9nyi \u00fat 12\u201316., 1115 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e1s","family":"Paksy","sequence":"additional","affiliation":[{"name":"Aesculap Akad\u00e9mia Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mih\u00e1ly","family":"Medvegy","sequence":"additional","affiliation":[{"name":"Kistarcsai Fl\u00f3r Ferenc K\u00f3rh\u00e1z, III. Belgy\u00f3gy\u00e1szat-Kardiol\u00f3giai Oszt\u00e1ly Kistarcsa Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krist\u00edna","family":"Gencsiov\u00e1","sequence":"additional","affiliation":[{"name":"D\u00e9l-budai Centrumk\u00f3rh\u00e1z \u2013 Szent Imre Egyetemi Oktat\u00f3k\u00f3rh\u00e1z, Anyagcsere K\u00f6zpont Budapest, T\u00e9t\u00e9nyi \u00fat 12\u201316., 1115 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erzs\u00e9bet Evelyn","family":"Sipos","sequence":"additional","affiliation":[{"name":"D\u00e9l-budai Centrumk\u00f3rh\u00e1z \u2013 Szent Imre Egyetemi Oktat\u00f3k\u00f3rh\u00e1z, Anyagcsere K\u00f6zpont Budapest, T\u00e9t\u00e9nyi \u00fat 12\u201316., 1115 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerg\u0151","family":"Csit\u00e1ri","sequence":"additional","affiliation":[{"name":"D\u00e9l-budai Centrumk\u00f3rh\u00e1z \u2013 Szent Imre Egyetemi Oktat\u00f3k\u00f3rh\u00e1z, Anyagcsere K\u00f6zpont Budapest, T\u00e9t\u00e9nyi \u00fat 12\u201316., 1115 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Gasparics","sequence":"additional","affiliation":[{"name":"D\u00e9l-budai Centrumk\u00f3rh\u00e1z \u2013 Szent Imre Egyetemi Oktat\u00f3k\u00f3rh\u00e1z, Anyagcsere K\u00f6zpont Budapest, T\u00e9t\u00e9nyi \u00fat 12\u201316., 1115 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ervin","family":"Finta","sequence":"additional","affiliation":[{"name":"D\u00e9l-budai Centrumk\u00f3rh\u00e1z \u2013 Szent Imre Egyetemi Oktat\u00f3k\u00f3rh\u00e1z, Kiemelt Hotelszolg\u00e1lat VIP-1 Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Tomcs\u00e1nyi J, B\u00f3zsik B, Rokszin Gy, et al. The prevalence of atrial\n                    fibrillation in Hungary. [A pitvarfibrill\u00e1ci\u00f3 prevalenci\u00e1ja Magyarorsz\u00e1gon.] Orv\n                    Hetil. 2012; 153: 339\u2013342. [Hungarian]","DOI":"10.1556\/OH.2012.29305"},{"key":"R2","doi-asserted-by":"crossref","unstructured":"Banerjee A, Taillandier S, Olesen JB, et al. Pattern of atrial\n                    fibrillation and risk of outcomes: the Loire valley atrial fibrillation project.\n                    Int J Cardiol 2013; 167: 2682\u20132687.","DOI":"10.1016\/j.ijcard.2012.06.118"},{"key":"R3","doi-asserted-by":"crossref","unstructured":"Van Gelder IC, Rienstra M, Bunting KV, et al. 2024 ESC guidelines\n                    for the management of atrial fibrillation developed in collaboration with the\n                    European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2024; 45:\n                    3314\u20133414.","DOI":"10.1093\/eurheartj\/ehae176"},{"key":"R4","doi-asserted-by":"crossref","unstructured":"Singer JD, Willett JB. Applied longitudinal data analysis: Modeling\n                    change and event occurrence. Oxford University Press, New York, NY, 2003. Online\n                    ed. 2009.","DOI":"10.1093\/acprof:oso\/9780195152968.001.0001"},{"key":"R5","doi-asserted-by":"crossref","unstructured":"Mills M. Introducing survival and event history analysis. Sage\n                    Publications, London, 2011.","DOI":"10.4135\/9781446268360"},{"key":"R6","doi-asserted-by":"crossref","unstructured":"Willett JB, Singer JD. Investigating onset, cessation, relapse, and\n                    recovery: why you should, and how you can, use discrete-time survival analysis\n                    to examine event occurrence. J Consult Clin. Psychol. 1993; 61:\n                    952\u2013965.","DOI":"10.1037\/0022-006X.61.6.952"},{"key":"R7","doi-asserted-by":"crossref","unstructured":"Banerjee A, Benedetto V, Gichuru P, et al. Adherence and persistence\n                    to direct oral anticoagulants in atrial fibrillation: a population-based study.\n                    Heart 2020; 106: 119\u2013126.","DOI":"10.1136\/heartjnl-2019-315307"},{"key":"R8","doi-asserted-by":"crossref","unstructured":"Bunting KV, Van Gelder IC, Kotecha D. STEEER-AF: a\n                    cluster-randomized education trial from the ESC. Eur Heart J. 2020; 41:\n                    1952\u20131954.","DOI":"10.1093\/eurheartj\/ehaa421"},{"key":"R9","unstructured":"Kotecha D. STEEER-AF \u2013 stroke prevention & rhythm control\n                    therapy: evaluation of an education programme of the European Society of\n                    Cardiology in a cluster-randomised trial in patients with atrial fibrillation.\n                    Presented at: ESC Congress, 2024. September 1, 2024, London."},{"key":"R10","doi-asserted-by":"crossref","unstructured":"Kiss RG. Direct oral anticoagulants in cardiology. [Direkt or\u00e1lis\n                    antikoagul\u00e1nsok a kardiol\u00f3gi\u00e1ban.] Orv Hetil. 2016; 157: 1507\u20131510.\n                    [Hungarian]","DOI":"10.1556\/650.2016.30578"},{"key":"R11","doi-asserted-by":"crossref","unstructured":"H\u00fcttl A, Nagy Z, Szentiv\u00e1nyi A, et al. Secondary ruptures of an\n                    abdominal aortic aneurysm treated with a physician-modified fenestrated\n                    endograft, endoanchors and finally with open repair. [Hasi aorta aneurysma\n                    m\u00e1sodlagos ruptur\u00e1inak kezel\u00e9se orvos \u00e1ltal m\u00f3dos\u00edtott fenesztr\u00e1lt grafttal,\n                    endocsavaroz\u00e1ssal, majd nyitott m\u0171t\u00e9ttel.] Orv Hetil. 2023; 164: 1426\u20131431.\n                    [Hungarian]","DOI":"10.1556\/650.2023.32856"},{"key":"R12","doi-asserted-by":"crossref","unstructured":"Shore S, Carey EP, Turakhia MP, et al. Adherence to dabigatran\n                    therapy and longitudinal patient outcomes: insights from the veterans health\n                    administration. 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