Would you start anticoagulation in a patient with provoked blood clot in the past now with labs done for rheumatological reasons showing triple positive APLA?

The short answer is that I would probably not anticoagulate this patient as a history of prior thrombosis is hard to connect to the currently positive APL antibodies. I would certainly obtain a second set for future risk stratification.

However, there are several variables that could influence the ...

Triple-positive APL labs are hard to ignore, especially a positive lupus anticoagulant (LAC). As above commented on, there are additional questions to ask: does the patient have lupus or similar systemic autoimmune disorder, is she on estrogens and/or a smoker, what was the initial "provoking" incid...

With a history of a PROVOKED thrombosis (and I would explore this in great detail to be assured that this historical feature is true), I would not. Education about how to AVOID clots on long trips or having to sit for prolonged periods of time is crucial here. I would also explore possible features ...