The long-term risk of myocardial infarction (MI) and recurrent ischemic stroke after a transient ischemic attack (TIA) or ischemic stroke is particularly high in patients with prior coronary artery disease (CAD).1,2 Recent trials of more intensive secondary prevention, such as those of lipid-lowering with the PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitors3–5 or those combining antithrombotic treatments,6 focused on patients with prior CAD. The gene discussed is PCSK9; the disease is transient ischemic attack.