SPARCL found that atorvastatin 80 mg daily reduced stroke recurrence in patients with- out another indication for statin therapy. TST confirmed that target LDL-C <70 mg/dL was superior to a target of 90 to 110 mg/dL for preventing major cardiovascular events. These 2 trials do not pertain to patients with car- dioembolic stroke and no atherosclerotic disease. These 2 stroke-specific trials are further supported by numer- ous RCTs of lipid-lowering drugs that indicate that high- risk patients with ASCVD should receive high-intensity statin therapy and that if LDL-C remains 70 mg/dL ( 1.8 mmol/L) on maximally tolerated statin therapy, it may be reasonable to add ezetimibe and then a PCSK-9 inhibitor if necessary and if patients are deemed to be at very high risk (Table 5). CLINICAL STATEMENTS AND GUIDELINES Kleindorfer The information in this table is from the 2018 AHA/ ACC guideline on the management of blood choles- For high-intensity statin therapy, the guideline recommends atorvastatin 80 mg daily or rosuvastatin 20 mg daily. Please refer to the guideline for contraindica- tions to high-intensity statin therapy and recommenda- tions for moderate-intensity statin therapy. Recommendation-Specific Supportive Text 1. The SPARCL trial included adults who had an ischemic or hemorrhagic stroke (or TIA presum- ably owing to atherosclerotic causes) in the prior 1 to 6 months and an LDL-C level of 100 to 190 mg/dL. The main exclusion criteria were coronary heart disease, peripheral vascular disease, AF, a prosthetic heart valve, clinically significant mitral stenosis, or sinus node dysfunction. There was no exclusion based on ischemic stroke subtype, although practically, most patients with cardioem- bolic stroke would be excluded on the basis of the exclusion criteria related to cardiac disease. Eligible patients were randomized to atorvastatin 80 mg or placebo. 