Statin and Dual Antiplatelet Therapy to Prevent Early Neurological Deterioration in Branch Atheromatous Disease

Exclusion Criteria

• •Age \< 20 years.
• •In the judgment of the treating physician
• •A candidate for thrombolysis, endarterectomy or endovascular intervention.
• •Receipt of any intravenous or intra-arterial thrombolysis within 1 week prior to index event.
• •Patients with more than 50% stenosis of the relevant arteries on magnetic resonance angiography (MRA), including intra- or extra-cranial internal carotid artery, middle cerebral artery or basilar artery.
• •Patients with high risk of cardioembolic source, such as atrial fibrillation, acute myocardial infarction, severe heart failure or valvular heart disease.
• •Other determined stroke etiology, such as vasculitis, shock, antiphospholipid antibody syndrome and etc.
• •Gastrointestinal bleed or major surgery within 3 months prior to index event.
• •History of nontraumatic intracranial hemorrhage.
• •Clear indication for anticoagulation during the study period (deep venous thrombosis, pulmonary embolism or hypercoagulable state).
• •Qualifying ischemic event induced by angiography or surgery.
• •Severe non-cardiovascular comorbidity with life expectancy \<3 months.
• •Contraindication to clopidogrel, aspirin, atorvastatin or rosuvastatin
• •Known allergy to clopidogrel, aspirin atorvastatin or rosuvastatin
• •Severe renal (serum creatinine \>2 mg/dL) or hepatic insufficiency (INR\>1.2; ALT\>40 U/L or any resultant complication, such as variceal bleeding, encephalopathy, or jaundice)
• •Hemostatic disorder or systemic bleeding in the past 3 months
• •Current thrombocytopenia (platelet count \<100 x109/L) or leukopenia (\<2 x109/L)
• •History of drug-induced hematologic or hepatic abnormalities
• •Anticipated requirement for long-term (\>7 day) non-study antiplatelet drugs (e.g., dipyridamole, ticagrelor, ticlopidine), or NSAIDs.
• •Low-density lipoprotein\<70mg/dl without prior statin treatment in recent one year or within 2 days after recruitment