What is the evidence for using a target range of INR of 2 to 3 for anticoagulation in patients with antiphospholipid syndrome?
Limited evidence favors anticoagulation with VKA compared with aspirin to reduce recurrent arterial thromboses. In a small (N=20) RCT, patients with antiphospholipid syndrome were assigned to a single-antiplatelet arm versus triple-therapy arm (dual antiplatelets plus anticoagulation). Participants with single antiplatelets had a higher risk of recurrent stroke (log-rank test, P=0.026) with similar rates of hemorrhage during a mean follow-up of 3.9 years.615 There are limited data to establish whether the addition of antiplatelets to anticoagulation is effective in reducing the risk of recurrent stroke in this population. The clinical consensus favors using only anticoagulation with a target INR range of 2 to 3 for antiphospholipid syndrome treatment.