{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:03:29Z","timestamp":1785506609989,"version":"3.56.0"},"reference-count":23,"publisher":"Akademiai Kiado Zrt.","issue":"20","license":[{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"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":[[2026,5,17]]},"abstract":"\n Bevezet\u00e9s:<\/jats:italic>\n A direkt or\u00e1lis antikoagul\u00e1nsok (DOAC-ok) alkalmaz\u00e1sa\n ellen\u00e9re is kialakulhat \u00fagynevezett \u00e1tt\u00f6r\u00e9ses akut ischaemi\u00e1s stroke. Nemzetk\u00f6zi\n adatok szerint az akut ischaemi\u00e1s stroke betegek 20%-a szed DOAC-ot, hazai\n \u00e1tfog\u00f3 elemz\u00e9s azonban err\u0151l az el\u0151fordul\u00e1sr\u00f3l eddig nem \u00e1llt rendelkez\u00e9sre.\n C\u00e9lkit\u0171z\u00e9s:<\/jats:italic>\n C\u00e9lunk a DOAC-ot szed\u0151k ar\u00e1ny\u00e1nak meghat\u00e1roz\u00e1sa\n volt az akut ischaemi\u00e1s stroke betegek k\u00f6r\u00e9ben.\n M\u00f3dszer:<\/jats:italic>\n Retrospekt\u00edv elemz\u00e9ssel \u00e9rt\u00e9kelt\u00fck a 2020. okt\u00f3ber 1. \u00e9s 2024. szeptember 30.\n k\u00f6z\u00f6tt ell\u00e1tott konszekut\u00edv akut ischaemi\u00e1s stroke betegek adatait, DOAC-szed\u00e9si\n szok\u00e1sait. Az adatgy\u0171jt\u00e9st a Semmelweis Egyetem stroke-regiszter\u00e9b\u0151l azonos\u00edtott\n betegekr\u0151l az eMedsol k\u00f3rh\u00e1zi informatikai rendszerben v\u00e9gezt\u00fck.\n Eredm\u00e9nyek:<\/jats:italic>\n A 2918 akut ischaemi\u00e1s stroke beteg k\u00f6z\u00fcl 320\n esetben volt dokument\u00e1lva DOAC-szed\u00e9s (10,57%), k\u00f6z\u00fcl\u00fck 276 beteg (86,25%)\n eset\u00e9ben az anamn\u00e9zisben pitvarfibrill\u00e1ci\u00f3 szerepelt. 183 beteg (57%) apixab\u00e1nt,\n 72 beteg (23%) rivaroxab\u00e1nt, 38 beteg (12%) dabigatr\u00e1nt, 27 beteg (8%) pedig\n edoxab\u00e1nt szedett. Az intrav\u00e9n\u00e1s thrombolysis id\u0151ablakait tekintve a standard\n (0\u20134,5 h) id\u0151ablakban 1379-b\u0151l 173 beteg (12,54%), m\u00edg a kiterjesztett\n id\u0151ablakban (4,5\u20139 h) 656-b\u00f3l 63 beteg (9,6%) szedett DOAC-ot a fenti\n betegpopul\u00e1ci\u00f3b\u00f3l. A DOAC-ot szed\u0151 akut ischaemi\u00e1s stroke betegek k\u00f6z\u00f6tt nagyobb\n volt a n\u0151k ar\u00e1nya (56,7%), \u00e9s magasabb volt az \u00e1tlag\u00e9letkor (76 \u00e9v), mint az\n akut ischaemi\u00e1s stroke popul\u00e1ci\u00f3 eg\u00e9sz\u00e9ben (70 \u00e9v).\n Megbesz\u00e9l\u00e9s:<\/jats:italic>\n A DOAC-szed\u00e9s 10,57%-os el\u0151fordul\u00e1sa a hazai\n akut ischaemi\u00e1s stroke betegek k\u00f6r\u00e9ben jelent\u0151sen kisebb ar\u00e1ny\u00fa, mint a\n nemzetk\u00f6zi irodalomban dokument\u00e1lt. Ennek h\u00e1tter\u00e9ben \u00e1llhat a DOAC-ok k\u00e9s\u0151bbi\n hazai bevezet\u00e9se, az elt\u00e9r\u0151 finansz\u00edroz\u00e1s, a nagy gy\u00f3gyszerk\u00f6lts\u00e9g. A\n k\u00fcl\u00f6nbs\u00e9get magyar\u00e1z\u00f3 t\u00e9nyez\u0151k felt\u00e1r\u00e1s\u00e1hoz tov\u00e1bbi vizsg\u00e1latok sz\u00fcks\u00e9gesek.\n K\u00f6vetkeztet\u00e9s:<\/jats:italic>\n A hazai akut ischaemi\u00e1s stroke betegek\n k\u00f6r\u00e9ben a DOAC-szed\u00e9s ar\u00e1nya elmaradt a nemzetk\u00f6zi \u00e1tlagt\u00f3l, ami c\u00e9lzott\n vizsg\u00e1latokat indokol az antikoagul\u00e1ci\u00f3s strat\u00e9gi\u00e1k optimaliz\u00e1l\u00e1sa \u00e9rdek\u00e9ben.\n Orv Hetil. 2026; 167(20): 779\u2013783.\n <\/jats:p>","DOI":"10.1556\/650.2026.33544","type":"journal-article","created":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T14:35:10Z","timestamp":1779028510000},"page":"779-783","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":0,"title":["A direkt or\u00e1lis v\u00e9ralvad\u00e1sg\u00e1tl\u00f3t szed\u0151k gyakoris\u00e1ga az akut ischaemi\u00e1s stroke miatt kezelt betegek k\u00f6z\u00f6tt"],"prefix":"10.1556","volume":"167","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0958-2316","authenticated-orcid":true,"given":"Bal\u00e1zs","family":"Fazekas","sequence":"first","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, S\u00fcrg\u0151ss\u00e9gi Orvostani Klinika Budapest, V\u00e1g\u00f3h\u00edd u. 23\u201329., 1097 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bence Barna","family":"Gunda","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Neurol\u00f3giai Klinika Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00e9ka","family":"Palicsek","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, S\u00fcrg\u0151ss\u00e9gi Orvostani Klinika Budapest, V\u00e1g\u00f3h\u00edd u. 23\u201329., 1097 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e1nk G\u00e1bor","family":"Fenyves","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, S\u00fcrg\u0151ss\u00e9gi Orvostani Klinika Budapest, V\u00e1g\u00f3h\u00edd u. 23\u201329., 1097 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Ferrari AJ, Santomauro DF, Aali A, et al. Global incidence,\n prevalence, years lived with disability (YLDs), disability-adjusted life-years\n (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204\n countries and territories and 811 subnational locations, 1990-2021: a systematic\n analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:\n 2133-2161.\n https:\/\/doi.org\/10.1016\/S0140-6736(24)00757-8","DOI":"10.1016\/S0140-6736(24)00757-8"},{"key":"R2","unstructured":"Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality\n from 235 causes of death for 20 age groups in 1990 and 2010: a systematic\n analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380:\n 2095-2128. Erratum: Lancet 2013; 381: 628."},{"key":"R3","doi-asserted-by":"crossref","unstructured":"Kov\u00e1cs B, Szap\u00e1ry L, S\u00e1ntics-Kajos LF, et al. Ischemic stroke in\n Europe: incidence trends over three decades (1991-2021). [Ischaemi\u00e1s stroke\n Eur\u00f3p\u00e1ban: incidenciatrendek h\u00e1rom \u00e9vtized t\u00e1vlat\u00e1ban (1991-2021)] Orv Hetil.\n 2025; 166: 1642-1652. [Hungarian]\n https:\/\/doi.org\/10.1556\/650.2025.33406","DOI":"10.1556\/650.2025.33406"},{"key":"R4","doi-asserted-by":"crossref","unstructured":"Papp T, Kiss Z, Rokszin G, et al. Mortality on DOACs versus on\n vitamin K antagonists in atrial fibrillation: analysis of the Hungarian health\n insurance fund database. Clin Ther. 2023; 45: 333-346.\n https:\/\/doi.org\/10.1016\/j.clinthera.2023.03.008","DOI":"10.1016\/j.clinthera.2023.03.008"},{"key":"R5","doi-asserted-by":"crossref","unstructured":"Rost NS, Giugliano RP, Ruff CT, et al. Outcomes with edoxaban versus\n warfarin in patients with previous cerebrovascular events: findings from ENGAGE\n AF-TIMI 48 (Effective anticoagulation with factor Xa next generation in atrial\n fibrillation-Thrombolysis in Myocardial Infarction 48). Stroke 2016; 47:\n 2075-2082.\n https:\/\/doi.org\/10.1161\/STROKEAHA.116.013540","DOI":"10.1161\/STROKEAHA.116.013540"},{"key":"R6","doi-asserted-by":"crossref","unstructured":"Chun KH, Lee H, Hong JH, et al. Prognosis of patients with ischemic\n stroke with prior anticoagulant therapy: direct oral anticoagulants versus\n warfarin. J Am Heart Assoc. 2024; 13: e034698.\n https:\/\/doi.org\/10.1161\/JAHA.124.034698","DOI":"10.1161\/JAHA.124.034698"},{"key":"R7","doi-asserted-by":"crossref","unstructured":"McGrath ER, Kapral MK, Fang J, et al. Association of atrial\n fibrillation with mortality and disability after ischemic stroke. Neurology\n 2013; 81: 825-832. Erratum: Neurology. 2016; 86: 492.\n https:\/\/doi.org\/10.1212\/WNL.0b013e3182a2cc15","DOI":"10.1212\/WNL.0b013e3182a2cc15"},{"key":"R8","doi-asserted-by":"crossref","unstructured":"Dimitriadis K, Pyrpyris N, Aznaouridis K, et al. Ischemic stroke in\n patients under oral anticoagulation: the Achilles heel of atrial fibrillation\n management. Brain Sci. 2025; 15: 454.\n https:\/\/doi.org\/10.3390\/brainsci15050454","DOI":"10.3390\/brainsci15050454"},{"key":"R9","doi-asserted-by":"crossref","unstructured":"Sawczy\u0144ska K, W\u0142odarczyk E, Pawlicka A, et al. Acute ischaemic\n stroke in patients treated with direct oral anticoagulants: potential causes,\n clinical characteristics, and short-term outcomes. Stroke Res Treat. 2024; 2024:\n 2285722. https:\/\/doi.org\/10.1155\/2024\/2285722","DOI":"10.1155\/2024\/2285722"},{"key":"R10","doi-asserted-by":"crossref","unstructured":"Berge E, Whiteley W, Audebert H, et al. European Stroke Organisation\n (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke. Eur\n Stroke J. 2021; 6: 1-62.\n https:\/\/doi.org\/10.1177\/2396987321989865","DOI":"10.1177\/2396987321989865"},{"key":"R11","doi-asserted-by":"crossref","unstructured":"Seiffge DJ, De Marchis GM, Koga M, et al. Ischemic stroke despite\n oral anticoagulant therapy in patients with atrial fibrillation. Ann Neurol.\n 2020; 8: 677-687. https:\/\/doi.org\/10.1002\/ana.25700","DOI":"10.1002\/ana.25700"},{"key":"R12","doi-asserted-by":"crossref","unstructured":"Ip YM, Lau KK, Ko H, et al. Association of alternative\n anticoagulation strategies and outcomes in patients with ischemic stroke while\n taking a direct oral anticoagulant. Neurology 2023; 101: E358-E369.\n https:\/\/doi.org\/10.1212\/WNL.0000000000207422","DOI":"10.1212\/WNL.0000000000208004"},{"key":"R13","doi-asserted-by":"crossref","unstructured":"Yaghi S, Henninger N, Giles JA, et al. Ischaemic stroke on\n anticoagulation therapy and early recurrence in acute cardioembolic stroke: the\n IAC study. J Neurol Neurosurg Psychiatry 2021; 92: 1062-1067.\n https:\/\/doi.org\/10.1136\/jnnp-2021-326166","DOI":"10.1136\/jnnp-2021-326166"},{"key":"R14","doi-asserted-by":"crossref","unstructured":"Bang OY, Park KM, Jeong DS. Occurrence of ischemic stroke in\n patients with atrial fibrillation receiving non-vitamin K oral anticoagulants:\n causes and prevention strategies. J Stroke 2023; 25: 199-213.\n https:\/\/doi.org\/10.5853\/jos.2022.03552","DOI":"10.5853\/jos.2022.03552"},{"key":"R15","doi-asserted-by":"crossref","unstructured":"Teow KH, Tan PS, Frost T, et al. Trends in direct oral anticoagulant\n use in patients presenting with acute stroke. Intern Med J. 2022; 52: 1633-1637.\n https:\/\/doi.org\/10.1111\/imj.15903","DOI":"10.1111\/imj.15903"},{"key":"R16","doi-asserted-by":"crossref","unstructured":"Johnson LS, Benz AP, Shoamanesh A, et al. Residual stroke risk among\n patients with atrial fibrillation prescribed oral anticoagulants: a\n patient-level meta-analysis from COMBINE AF. J Am Heart Assoc. 2024; 13: e34758.\n https:\/\/doi.org\/10.1161\/JAHA.123.034758","DOI":"10.1161\/JAHA.123.034758"},{"key":"R17","doi-asserted-by":"crossref","unstructured":"Papp T, Kiss Z, Rokszin G, et al. Mortality on DOACs versus on\n vitamin K antagonists in atrial fibrillation: analysis of the Hungarian Health\n Insurance Fund Database. Clin Ther. 2023; 45: 333-346.\n https:\/\/doi.org\/10.1016\/j.clinthera.2023.03.008","DOI":"10.1016\/j.clinthera.2023.03.008"},{"key":"R18","doi-asserted-by":"crossref","unstructured":"Sabat\u00e9 M, Vidal X, Ballarin E, et al. Adherence to direct oral\n anticoagulants in patients with non-valvular atrial fibrillation: a\n cross-national comparison in six European countries (2008-2015). Front\n Pharmacol. 2021; 12: 682890.\n https:\/\/doi.org\/10.3389\/fphar.2021.682890","DOI":"10.3389\/fphar.2021.682890"},{"key":"R19","doi-asserted-by":"crossref","unstructured":"Chao TF, Potpara TS, Lip GY. Atrial fibrillation: stroke prevention.\n Lancet Reg Health Eur. 2024; 37: 100797.\n https:\/\/doi.org\/10.1016\/j.lanepe.2023.100797","DOI":"10.1016\/j.lanepe.2023.100797"},{"key":"R20","doi-asserted-by":"crossref","unstructured":"Mayer-Suess L, Rinner H, Lang W, et al. Risk of stroke in patients\n with prior VKA or DOAC: A population-based real-world registry analysis. Eur\n Stroke J. 2024; 9: 418-423.\n https:\/\/doi.org\/10.1177\/23969873231223876","DOI":"10.1177\/23969873231223876"},{"key":"R21","doi-asserted-by":"crossref","unstructured":"Z\u00e1troch I, Fazakas J. Management of emergencies in direct oral\n anticoagulant-treated patients: practice pearls. [Direkt or\u00e1lis antikoagul\u00e1nst\n szed\u0151 betegek s\u00fcrg\u0151ss\u00e9gi ell\u00e1t\u00e1sa: gyakorlati szempontok.] Orv Hetil. 2025; 166:\n 1043-1052. [Hungarian]\n https:\/\/doi.org\/10.1556\/650.2025.33299","DOI":"10.1556\/650.2025.33299"},{"key":"R22","doi-asserted-by":"crossref","unstructured":"Cakmak S, Simsekoglu R. Evaluating acute ischemic strokes despite\n regular anticoagulation: a comparative analysis of direct oral anticoagulants\n and warfarin in treatment outcomes. Int J Clin Pract. 2024; 2024: 7676634.\n https:\/\/doi.org\/10.1155\/2024\/7676634","DOI":"10.1155\/2024\/7676634"},{"key":"R23","doi-asserted-by":"crossref","unstructured":"Lin DS, Lo HY, Huang KC, et al. Efficacy and safety of direct oral\n anticoagulants for stroke prevention in older patients with atrial fibrillation:\n a network meta-analysis of randomized controlled trials. J Am Heart Assoc. 2023;\n 12: e030380. https:\/\/doi.org\/10.1161\/JAHA.123.030380","DOI":"10.1161\/JAHA.123.030380"}],"container-title":["Orvosi Hetilap"],"original-title":[],"link":[{"URL":"https:\/\/www.akjournals.com\/view\/journals\/650\/167\/20\/article-p779.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.akjournals.com\/downloadpdf\/journals\/650\/167\/20\/article-p779.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.akjournals.com\/downloadpdf\/journals\/650\/167\/20\/article-p779.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T13:13:08Z","timestamp":1785503588000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.akjournals.com\/view\/journals\/650\/167\/20\/article-p779.xml"}},"subtitle":["A Semmelweis Egyetem stroke-regiszter adatainak\n elemz\u00e9se"],"short-title":[],"issued":{"date-parts":[[2026,5,17]]},"references-count":23,"journal-issue":{"issue":"20"},"URL":"https:\/\/doi.org\/10.1556\/650.2026.33544","relation":{},"ISSN":["0030-6002","1788-6120"],"issn-type":[{"value":"0030-6002","type":"print"},{"value":"1788-6120","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,17]]}}}