The antiphospholipid-antibody syndrome (APS) is a thrombophilic disorder characterized by recurrent venous or arterial thrombosis, often associated with antiphospholipid antibodies such as anticardiolipin antibodies or the lupus anticoagulant. It can occur in systemic lupus erythematosus (SLE) or as a primary condition in patients without SLE features. The syndrome is associated with thrombocytopenia, recurrent spontaneous abortion, and a high risk of recurrent thrombosis. The optimal treatment for APS remains unclear, but this study evaluated the efficacy of warfarin, low-dose aspirin, or both in preventing thrombosis in patients with APS. A retrospective study of 147 patients with APS and a history of thrombosis found that high-intensity warfarin (international normalized ratio [INR] ≥3) with or without low-dose aspirin was significantly more effective in preventing thrombosis recurrence than low-intensity warfarin (INR <3) or aspirin alone. The recurrence rate was highest in the first six months after stopping warfarin. Bleeding complications occurred in 29 patients, with 7 having severe bleeding. Long-term anticoagulation with INR ≥3 was recommended to reduce the risk of recurrent thrombosis, despite the risk of bleeding. Aspirin alone showed no significant benefit in preventing thrombosis recurrence after adjusting for other risk factors. Low-intensity anticoagulation (INR 2-3) did not prevent thrombosis in patients with APS. The study concluded that long-term anticoagulation with INR ≥3 is advisable for patients with APS, as the benefits outweigh the risks of bleeding. Controlled prospective studies are needed to confirm these findings.The antiphospholipid-antibody syndrome (APS) is a thrombophilic disorder characterized by recurrent venous or arterial thrombosis, often associated with antiphospholipid antibodies such as anticardiolipin antibodies or the lupus anticoagulant. It can occur in systemic lupus erythematosus (SLE) or as a primary condition in patients without SLE features. The syndrome is associated with thrombocytopenia, recurrent spontaneous abortion, and a high risk of recurrent thrombosis. The optimal treatment for APS remains unclear, but this study evaluated the efficacy of warfarin, low-dose aspirin, or both in preventing thrombosis in patients with APS. A retrospective study of 147 patients with APS and a history of thrombosis found that high-intensity warfarin (international normalized ratio [INR] ≥3) with or without low-dose aspirin was significantly more effective in preventing thrombosis recurrence than low-intensity warfarin (INR <3) or aspirin alone. The recurrence rate was highest in the first six months after stopping warfarin. Bleeding complications occurred in 29 patients, with 7 having severe bleeding. Long-term anticoagulation with INR ≥3 was recommended to reduce the risk of recurrent thrombosis, despite the risk of bleeding. Aspirin alone showed no significant benefit in preventing thrombosis recurrence after adjusting for other risk factors. Low-intensity anticoagulation (INR 2-3) did not prevent thrombosis in patients with APS. The study concluded that long-term anticoagulation with INR ≥3 is advisable for patients with APS, as the benefits outweigh the risks of bleeding. Controlled prospective studies are needed to confirm these findings.