We live in exciting times with the development of several new oral anticoagulant agents, including the recent approval of the direct thrombin inhibitor dabigatran for the prevention of stroke and systemic embolism in patients with atrial fibrillation (AF). Dabigatran, an oral agent with fixed dosing, is an attractive alternative to warfarin which has recently been made available in the UK. What are the implications for UK primary care? Many patients with AF receive substandard anticoagulation and are therefore at risk of stroke. Evidence for its efficacy and its potential place in clinical practice is reviewed.
