For which subset(s) of APS patients do you recommend an INR of 3 or higher?

According to the EULAR 2019 recommendations for managing APL (Tektonidou et al., PMID 31092409) and according to the 2011 APL Task Force recommendations: For secondary venous thrombosis prophylaxis, it is recommended to keep INR between 2-3. Patients who fail warfarin therapy at INR 2-3 may benefit from increasing their INR goal to 3-4. However, it is important to know whether patients were adherent to their treatments before declaring a treatment failure and whether INR measurements were accurate (INR measurements can be erroneously elevated in APL patients).

For secondary arterial thrombosis prophylaxis, warfarin alone can be used to achieve the INR goal of 3-4. Alternatively, warfarin with low dose aspirin can be used with the INR goal of...