For a patient with acute stroke who cannot tolerate statins, what is your preferred second-line agent for secondary prevention?

First question - is the patient experiencing the nocebo effect? I would explore statin-based symptoms. Ezetimibe - if only needs a small reduction. If you need to be more aggressive, I would use PCSK9 inhibitors. If the patient cannot tolerate a PCSK9 inhibitor or if you need more lowering, you can ...