{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,3]],"date-time":"2022-04-03T05:14:14Z","timestamp":1648962854477},"reference-count":22,"publisher":"Akademiai Kiado Zrt.","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,2,1]]},"abstract":"<jats:p>A kardiog\u00e9n stroke a j\u00f6v\u0151ben egyre nagyobb jelent\u0151s\u00e9g\u0171v\u00e9 v\u00e1lik gyakoris\u00e1ga n\u00f6veked\u00e9se miatt. Ischaemi\u00e1s esem\u00e9nyt m\u00e9g nem szenvedett pitvarfibrill\u00e1l\u00f3 beteg eset\u00e9n kock\u00e1zatbecsl\u00e9st kell v\u00e9gezni \u00e9s annak alapj\u00e1n d\u00f6nteni a v\u00e9rlemezkeg\u00e1tl\u00f3 vagy antikoagul\u00e1ns kezel\u00e9sr\u0151l. (A legt\u00f6bb pitvarfibrill\u00e1l\u00f3 esetet antikoagul\u00e1lni kell.) A pitvarfibrill\u00e1ci\u00f3 s\u00falyos stroke-kock\u00e1zati t\u00e9nyez\u0151, ez\u00e9rt pitvarfibrill\u00e1l\u00f3 betegekn\u00e9l az antikoagul\u00e1l\u00e1s a primer prevenci\u00f3 r\u00e9sze (kiv\u00e9tel: fiatal, egy\u00e9b kock\u00e1zati t\u00e9nyez\u0151vel nem rendelkez\u0151 pitvarfibrill\u00e1l\u00f3 szem\u00e9ly). Hetven\u00f6t \u00e9vn\u00e9l id\u0151sebb pitvarfibrill\u00e1l\u00f3 beteg is antikoagul\u00e1lhat\u00f3, megfelel\u0151en ellen\u0151rz\u00f6tt INR-\u00e9rt\u00e9kek mellett. A szerz\u0151k \u00e1ttekintik az egy\u00e9b sz\u00edvbetegs\u00e9geket is, k\u00fcl\u00f6n\u00f6s tekintettel a billenty\u0171betegs\u00e9gekre \u00e9s a sz\u00edvinfarktusra. Akut stroke-ban az \u00faj eur\u00f3pai \u00fatmutat\u00f3 nem javasolja sem a hagyom\u00e1nyos, sem a frakcion\u00e1lt heparin haszn\u00e1lat\u00e1t. Ischaemi\u00e1s stroke-ban aszpirinkezel\u00e9st alkalmazunk az els\u0151 h\u00e1rom napban, \u00e9s ezt k\u00f6vet\u0151en t\u00e9r\u00fcnk \u00e1t tart\u00f3s antikoagul\u00e1ns kezel\u00e9sre, \u00e9s csak akkor, ha emb\u00f3liaforr\u00e1st tudtunk igazolni, illetve a beteg egy\u00fcttm\u0171k\u00f6d\u00e9se megfelel\u0151, a v\u00e9rz\u00e9svesz\u00e9ly viszonylag kicsi (INR 2-3). Egy\u00e9bk\u00e9nt csak v\u00e9rlemezkeg\u00e1tl\u00f3 kezel\u00e9st alkalmazunk. N\u00e9h\u00e1ny k\u00fcl\u00f6nleges esetben egyes szerz\u0151k javallj\u00e1k a korai antikoagul\u00e1l\u00e1st (az \u00fajabb emboliz\u00e1ci\u00f3 vesz\u00e9lye extr\u00e9m nagy, bal pitvari\/kamrai thrombus, art\u00e9riadissectio vagy seb\u00e9szi beavatkoz\u00e1s s\u00falyos art\u00e9riastenosis mellett), m\u00e1s esetben pedig \u00f3vatoss\u00e1gra intenek (kiterjedt infarktus, nem megfelel\u0151 m\u00f3don kontroll\u00e1lhat\u00f3 v\u00e9rnyom\u00e1s, s\u00falyos microvascularis elv\u00e1ltoz\u00e1sok). A szekunder prevenci\u00f3 st\u00e1dium\u00e1ban nincs k\u00fcl\u00f6nbs\u00e9g a v\u00e9rlemezkeg\u00e1tl\u00f3 \u00e9s az antikoagul\u00e1ns kezel\u00e9s hat\u00e1soss\u00e1ga k\u00f6z\u00f6tt, els\u0151sorban v\u00e9rlemezkeg\u00e1tl\u00f3 kezel\u00e9s j\u00f6n sz\u00f3ba, kiv\u00e9ve azokat az eseteket, amikor a sz\u00edv emb\u00f3liaforr\u00e1s.<\/jats:p>","DOI":"10.1556\/oh.2009.28414","type":"journal-article","created":{"date-parts":[[2009,1,22]],"date-time":"2009-01-22T02:18:59Z","timestamp":1232590739000},"page":"195-202","source":"Crossref","is-referenced-by-count":0,"title":["Antithrombotic therapy in primary and secondary stroke prevention of cardiac patients and in acute stroke"],"prefix":"10.1556","volume":"150","author":[{"given":"L\u00e1szl\u00f3","family":"Csiba","sequence":"first","affiliation":[{"name":"1 Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Orvos- \u00e9s Eg\u00e9szs\u00e9gtudom\u00e1nyi Centrum Neurol\u00f3giai Klinika Debrecen M\u00f3ricz Zsigmond krt. 22. 4032"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katalin R\u00e9ka","family":"Kov\u00e1cs","sequence":"additional","affiliation":[{"name":"2 Megyei K\u00f3rh\u00e1z Neurol\u00f3giai Klinika Marosv\u00e1s\u00e1rhely"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"atypb1","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/S1474-4422(04)00967-6","volume":"4","year":"2005","journal-title":"Lancet Neurol."},{"key":"atypb2","first-page":"873","volume":"113","year":"2006","journal-title":"Circulation"},{"key":"atypb3","doi-asserted-by":"crossref","first-page":"857","DOI":"10.7326\/0003-4819-146-12-200706190-00007","volume":"146","year":"2007","journal-title":"Ann. 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