Dear Editor, over the last decades lipid-modifying strategies made a pivotal change in cardiovascular prevention especially in patients with previous coronary artery disease or ischemic stroke. In these patients, low-density lipoprotein cholesterol (LDL-C) reduction is directly correlated to less future cardiovascular events, an association mediated by its effect on the burden of atherosclerosis [1]. In contrast to coronary and peripheral artery disease which are mainly caused by atherosclerosis, stroke is a heterogenous disease with distinct pathophysiological mechanisms (like atherosclerosis, atrial fibrillation (AF), patent foramen ovale, dissection, small vessel disease) that frequently overlap [2].