Eligible patients were randomized to atorvastatin 80 mg or placebo. During a median follow-up of 4.9 years, the primary end point of stroke occurred in 11.2% of patients receiving atorvastatin versus 13.1% of patients receiving placebo (adjusted HR, 2. The TST trial included adults with cerebral infarction in the prior 3 months or high-risk TIA (that included at least arm and leg motor deficit or speech disturbance lasting >10 minutes) in the prior 15 days, documented atherosclerotic disease (defined as carotid, aortic, intracranial, or coronary atherosclerotic disease), and a clear indication for statin therapy. The main exclu- sion criteria were a cardioembolic stroke/TIA without documented atherosclerotic disease, a baseline LDL-C <100 mg/dL while not taking a statin, inability to intensify statin therapy (already on maximum dose), or a history of symptomatic hemorrhagic stroke. Eligible patients were ran- domly assigned to an LDL-C target of <70 mg/ dL (lower-target group) versus 90 to 110 mg/ dL (higher-target group). LDL-C targets were pursued by intensification of statin therapy and the addition of ezetimibe if needed. During a median 3.5 years of follow-up, the primary com- posite outcome of major cardiovascular events occurred in 8.5% of those in the lower-target group versus 10.9% in the higher-target group In addi- tion, a secondary analysis of the IMPROVE-IT trial (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) found a significantly lower risk of ischemic stroke with ezetimibe treatment (in addition to simvastatin) among patients with previous MI.216 3. Very high-risk patients include those with history of multiple major ASCVD events or 1 major ASCVD event and multiple high-risk conditions. 