Question

A 62-year-old with HFrEF (EF 28%) on lisinopril and metoprolol remains NYHA II. Creatinine 1.0 mg/dL, potassium 4.5 mEq/L, BP 118/72 mm Hg, A1c 6.9%. According to current guidelines, which additional therapy most strongly reduces HF hospitalizations and CV death regardless of diabetes status?

Accepted Answer

Start dapagliflozin 10 mg daily

Answer

Add ivabradine 5 mg twice daily

Answer

Up-titrate ACE inhibitor to maximum dose only

Answer

Switch to loop plus thiazide diuretics

Answer

Begin hydralazine-isosorbide dinitrate in all patients

Practice question

A 62-year-old with HFrEF (EF 28%) on lisinopril and metoprolol remains NYHA II. Creatinine 1.0 mg/dL, potassium 4.5 mEq/L, BP 118/72 mm Hg, A1c 6.9%. According to current guidelines, which additional therapy most strongly reduces HF hospitalizations and CV death regardless of diabetes status?