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ModerateCardiologyHeart Failure with Reduced Ejection Fractionus-abimus-usmle-step-2us-usmle-step-3

A 60-year-old with HFrEF (LVEF 25%) and NYHA II is on sacubitril/valsartan and metoprolol succinate. Creatinine 1.0 mg/dL, K⁺ 4.4 mEq/L, eGFR 70 mL/min/1.73 m². Not on MRA or SGLT2 inhibitor. What therapy should be added next to reduce mortality and hospitalisations?

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