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MediumCardiologyHeart Failure with Reduced Ejection Fraction (HFrEF)ukmlamrcgp aktpanemrcp part 1prescribing safety assessment

A 68-year-old man with chronic heart failure due to ischaemic heart disease (LVEF 35%) remains symptomatic (NYHA Class II) despite optimal doses of Ramipril (10mg OD) and Bisoprolol (10mg OD). His BP is 120/75 mmHg and eGFR is 55 ml/min/1.73m². According to NICE NG106, which medication should be added next to improve mortality?

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