Thrombosis is a terminal stage of the disease leading to death in the most frequent diseases as myocardial infarction, stroke, deep thrombosis and cancer. New strategies for antithrombotics are related to new innovative medicaments, targeted via their mechanism of effect to the factor Xa or thrombin, which have the potential to replace warfarin and heparin as well as low molecular heparins for treatment and prophylaxis of thromboembolic diseases. New medicaments are promising for improvement of suitability, safety and for same if not improved effectiveness. The results of long-term and extensive clinical studies proved apparent benefits of such therapy. Oral direct inhibitors of thrombin (dabigatran) and factor Xa (apixaban and rivaroxaban) open new perspectives for prevention of deep vein thrombosis, thromboembolism and clinical complications after acute coronary syndrome.