Would you start anticoagulation in a patient with a history of CVA 1 year ago and high risk APL profile who was never started on anticoagulation, but is now presenting for follow up and without recurrent thrombotic events?

This is a difficult question. The details here are important. Therapeutically, you can go either way in my opinion. Were the positive antiphospholipid antibodies checked again later? Did the patient have an infection when the APS labs were first done? Does the patient have diabetes or other CV risk ...

Yes, I would start anticoagulation in this patient.

Yes, anticoagulation is getting safer and is now worth it in this case.

Yes. Simply because it was not done previously is no reason to start now if warranted. And according to the history given it is warranted. Treat to prevent the (anticipated) next event.