{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:05:11Z","timestamp":1785423911563,"version":"3.56.0"},"reference-count":89,"publisher":"Akademiai Kiado Zrt.","issue":"27","license":[{"start":{"date-parts":[[2025,7,6]],"date-time":"2025-07-06T00:00:00Z","timestamp":1751760000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2025,7,6]]},"abstract":"<jats:p>A direkt or\u00e1lis antikoagul\u00e1nsok az elm\u00falt \u00e9vekben a v\u00e9ralvad\u00e1sg\u00e1tl\u00f3 kezel\u00e9s els\u0151\n                    vonalbeli szereiv\u00e9 v\u00e1ltak, azonban s\u00fcrg\u0151ss\u00e9gi helyzetekben \u2013 p\u00e9ld\u00e1ul massz\u00edv\n                    v\u00e9rz\u00e9s, akut m\u0171t\u00e9t \u2013 kih\u00edv\u00e1st jelenthet hat\u00e1suk felf\u00fcggeszt\u00e9se. A hagyom\u00e1nyos\n                    v\u00e9ralvad\u00e1si vizsg\u00e1latok nem ny\u00fajtanak megb\u00edzhat\u00f3 inform\u00e1ci\u00f3t e szerek hat\u00e1s\u00e1nak\n                    pontos felm\u00e9r\u00e9s\u00e9re, ez\u00e9rt specifikus monitoroz\u00e1si m\u00f3dszerek (p\u00e9ld\u00e1ul\n                    anti-FXa-teszt, viszkoelasztikus tesztek) alkalmaz\u00e1sa javasolt. Az antidotumok\n                    k\u00f6z\u00fcl az idarucizumab a dabigatr\u00e1n hat\u00e1s\u00e1nak gyors felf\u00fcggeszt\u00e9s\u00e9re, m\u00edg az\n                    andexanet-alfa az aktiv\u00e1lt X-es faktort g\u00e1tl\u00f3k k\u00f6z\u00fcl az apixab\u00e1n \u00e9s a\n                    rivaroxab\u00e1n hat\u00e1s\u00e1nak semleges\u00edt\u00e9s\u00e9re haszn\u00e1lhat\u00f3, b\u00e1r az ut\u00f3bbi el\u00e9rhet\u0151s\u00e9ge \u00e9s\n                    a nagyobb thrombosiskock\u00e1zat korl\u00e1tozza alkalmaz\u00e1s\u00e1t. Alternat\u00edv ter\u00e1piak\u00e9nt\n                    protrombinkomplex-koncentr\u00e1tum vagy extracorporalis technik\u00e1k is sz\u00f3ba j\u00f6hetnek.\n                    A s\u00fcrg\u0151ss\u00e9gi beavatkoz\u00e1s el\u0151tt az antikoagul\u00e1ns plazmakoncentr\u00e1ci\u00f3j\u00e1nak\n                    meghat\u00e1roz\u00e1sa seg\u00edti a d\u00f6nt\u00e9shozatalt, de sz\u00fcks\u00e9g eset\u00e9n a v\u00e9rz\u00e9scsillap\u00edt\u00f3\n                    ter\u00e1pia e n\u00e9lk\u00fcl is megkezdhet\u0151. A v\u00e9rz\u00e9s kezel\u00e9se ut\u00e1n az antikoagul\u00e1ci\u00f3\n                    miel\u0151bbi \u00fajrakezd\u00e9se kulcsfontoss\u00e1g\u00fa a thrombosiskock\u00e1zat cs\u00f6kkent\u00e9se \u00e9rdek\u00e9ben.\n                    Orv Hetil. 2025; 166(27): 1043\u20131052.<\/jats:p>","DOI":"10.1556\/650.2025.33299","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T07:01:46Z","timestamp":1753081306000},"page":"1043-1052","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":3,"title":["Direkt or\u00e1lis antikoagul\u00e1nst szed\u0151 betegek s\u00fcrg\u0151ss\u00e9gi ell\u00e1t\u00e1sa: gyakorlati szempontok"],"prefix":"10.1556","volume":"166","author":[{"given":"Istv\u00e1n","family":"Z\u00e1troch","sequence":"first","affiliation":[{"name":"Semmelweis Egyetem, R\u00e1cz K\u00e1roly Doktori Iskola Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e1nos","family":"Fazakas","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Intenz\u00edv Ter\u00e1pi\u00e1s Klinika, Aneszteziol\u00f3giai \u00e9s Intenz\u00edv Ter\u00e1pi\u00e1s Tansz\u00e9k Budapest, Pf. 2, 1428 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"January CT, Wann LS, Calkins H, et al. 2019 AHA\/ACC\/HRS focused\n                    update of the 2014 AHA\/ACC\/HRS guideline for the management of patients with\n                    atrial fibrillation: a report of the American College of Cardiology\/American\n                    Heart Association task force on clinical practice guidelines and the Heart\n                    Rhythm Society in collaboration with the Society of Thoracic Surgeons.\n                    Circulation 2019; 140: e125\u2013e151.","DOI":"10.1161\/CIR.0000000000000665"},{"key":"R2","doi-asserted-by":"crossref","unstructured":"Steffel J, Verhamme P, Potpara TS, et al. The 2018 European Heart\n                    Rhythm Association practical Guide on the use of non-vitamin K antagonist oral\n                    anticoagulants in patients with atrial fibrillation. Eur Heart J. 2018; 39:\n                    1330\u20131393.","DOI":"10.1093\/eurheartj\/ehy136"},{"key":"R3","doi-asserted-by":"crossref","unstructured":"Eikelboom JW, Connolly SJ, Brueckmann M, et al. Dabigatran versus\n                    warfarin in patients with mechanical heart valves. N Engl J Med. 2013; 369:\n                    1206\u20131214.","DOI":"10.1056\/NEJMoa1300615"},{"key":"R4","doi-asserted-by":"crossref","unstructured":"Pengo V, Denas G, Zoppellaro G, et al. Rivaroxaban vs warfarin in\n                    high-risk patients with antiphospholipid syndrome. Blood 2018; 132:\n                    1365\u20131371.","DOI":"10.1182\/blood-2018-04-848333"},{"key":"R5","doi-asserted-by":"crossref","unstructured":"Pengo V, Hoxha A, Andreoli L, et al. 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