Inclusion Criteria:
* Patients with clinical ischemic stroke able to enroll between 72 hours and 7 days after symptom onset.
* Patients age 18-85, inclusive.
* NIHSS score of 4-21, inclusive, prior to treatment.
* Signed IRB-approved informed consent by patient or authorized representative.
Exclusion Criteria:
General
* Participation in another study with an investigational drug or device.
* Women known to be pregnant, lactating, or of childbearing potential with a positive urine beta-HCG.
* Patients using niacin within the 7 days previous to their stroke.
Safety Related
* Unstable angina.
* Acute Myocardial infarction.
* Concurrent arterial bleeding.
* Active peptic ulcer disease.
* Platelet count less than 100,000 per microliter.
* Internationally Normalized Ratio (INR) greater than 1.3 without use of warfarin.
* Concurrent use of bile acid sequestrants (colestipol and cholestyramine)
* Baseline systolic blood pressure less than 100 mmHg.
* History of significant hepatic dysfunction.
* Allergy or hypersensitivity to aspirin.
* Concurrent use of amiodarone, gemfibrozil, fibrate or other bile acid resin, cyclosporine, itraconazole, ketaconazole, telithromycin, erythromycin, clarithromycin, HIV protease inhibitors, nefazodone, danazol.
* Allergy or hypersensitivity to extended-release niacin.
* Allergy or hypersensitivity to statin agents.
Potentially Interfering with Outcomes Assessment
* Prior history of dementia.
* Patients without fixed address or those deemed unlikely to present for follow-up by the investigator.
* Patients whose life expectancy is less than 24 weeks.
* Pre-stroke modified Rankin score\>2.
* Glucose less than 50 mg/dl.
* Other serious illness (e.g., severe hepatic, cardiac, or renal failure; or a complex disease that may confound treatment assessment).
Imaging Related
* Evidence of primary intra-parenchymal hemorrhage on initial neuroimaging study.
* Neuroimaging evidence of a nonvascular cause for the neurological symptoms.
