Question

A 58-year-old with HFrEF (LVEF 30%), NYHA II, on guideline doses of ARNI, beta blocker, and MRA has eGFR 45 mL/min/1.73 m² and albuminuria. Which addition improves HF outcomes and is indicated now?

Accepted Answer

Start an SGLT2 inhibitor (e.g., empagliflozin)

Answer

Increase loop diuretic dose

Answer

Add ivabradine

Answer

Start isosorbide dinitrate/hydralazine for all patients

Answer

Switch ARNI to ACE inhibitor

Practice question

A 58-year-old with HFrEF (LVEF 30%), NYHA II, on guideline doses of ARNI, beta blocker, and MRA has eGFR 45 mL/min/1.73 m² and albuminuria. Which addition improves HF outcomes and is indicated now?