Intensive Medical Therapy for High-risk Intracranial or Extracranial Atherosclerosis

Inclusion Criteria:

1. Age :35-80 years old , male or female;
2. Any of the following three two situations:

(1) Mild ischemic stroke (NIHSS 4 to 5 points) within 24 hours of onset meets any of thefollowing imaging conditions:

1. Acute single cerebral infarction with criminal intracranial and extracranialatherosclerotic stenosis (stenosis rate ≥50%)
2. Acute multiple cerebral infarction (considered to be caused by large arteryatherosclerosis, including non-stenotic vulnerable plaque) Or (2) Moderate-to-high-risk TIA (ABCD2≥4 points) or mild ischemic stroke (NIHSS≤5 points)within 24 to 72 hours of onset meets any of the following imaging conditions:
3. Medium and high risk TIA with criminal intracranial and extracranial atheroscleroticstenosis (stenosis rate ≥50%)
4. Acute single cerebral infarction with criminal intracranial and extracranialatherosclerotic stenosis (stenosis rate ≥50%)
5. Acute multiple cerebral infarction (considered to be caused by large arteryatherosclerosis, including non-stenotic vulnerable plaque) The rate of intracranial artery stenosis is assessed by MRA, CTA, or DSA according to WASIDstandards; the rate of extracranial artery stenosis is assessed by carotid ultrasound,CEMRA, CTA or DSA, according to NASCET standards; 3. Signed informed consent

Exclusion Criteria:

1. Specific cardiogenic ischemic cerebrovascular diseases(eg. combined with atrialfibrillation, heart valve prosthesis, atrial myxoma, endocarditis, etc.)
2. Other ischemic cerebrovascular diseases with specific causes (eg. aortic dissection,vasculitis, vascular malformation, etc.)
3. Non-cerebral vascular disease (eg. intracranial tumors, multiple sclerosis)
4. Cerebral infarction of large area (infarct size greater than half the single lobearea)
5. CT indicating hemorrhagic transformation of cerebral infarction before randomization
6. Patients with pre-existing contraindications of using clopidogrel, aspirin or statindrugs: Known history of allergy ; Severe heart failure and asthma ; Coagulant disorders andsystemic bleeding ; Pre-existing drug - induced blood system disease or abnormal liverfunction ; Leukopenia (< 2×109/l) or thrombocytopenia (<100×109/l) ; active liverdisease ; pregnancy or lactation period ; Severe heart failure：New York HeartAssociation (NYHA) Functional Classification III and IV
7. MRS > 2 before the onset
8. Use of intravenous or arterial thrombolysis intravascular therapy or bridge therapyafter onset
9. Use of defibrinating therapy like snake venom, defibrase, lumbrokinase, etc. or use ofanticoagulant therapy like argatroban, or use of antiplatelet therapy exceptclopidogrel and aspirin, such as tirofiban, ticagrelor, ozagrel, and so on afteronset.
10. Creatine Kinase(CK) more than 5 times of the upper limit of normal value after onset
11. Use of drugs affecting the metabolism of statins such as immune-suppressive drugs,antifungal agents, or fibrates drugs and so on, within 14 days before randomization.
12. Severe hepatic or renal insufficiency (Note: Severe hepatic insufficiency refers tothe ALT value > 2 times the upper limit of normal value or AST times > 2 times theupper limit of normal value; Severe hepatic insufficiency is refers to creatininevalues > 1.5 times he upper limit of normal value or GFR < 40 ml/min/1.73 m2)
13. Usage of dual antiplatelet therapy with aspirin plus clopidogrel within 14 days beforerandomization. (patients who received dual antiplatelet therapy (aspirin combined withclopidogrel) but did not use clopidogrel with loading dose after onset were excluded)
14. Use of Intensive statin therapy within 14 days before randomization（atorvastatin ≥40mg/d or rosuvastatin ≥ 20mg/d）.
15. Pre-existing intracranial hemorrhage（eg. ICH, SAH）
16. Gastrointestinal bleeding or major surgery occurred within 90 days beforerandomization.
17. Pre-existing extracranial angioplasty or vascular surgery
18. Anticipated requirement for long-term non-study antiplatelet drugs, or non-steroidanti-inflammatory drugs.
19. Experimental drugs need to stop due to angioplasty or vascular surgery, which wasplanned or likely to perform within 90 days after randomization
20. Patients with severe disease expected to live for less than 90 days
21. Pregnant or childbearing-age women who have no effective contraceptives or positivepregnancy test records
22. Patients who are undergoing experimental drugs or device tests
23. Unable to finish the follow-up of 90 days due to geographical factor or otherreasons（eg. dementia, alcoholism, substance abuse, severe mental disease, etc.）