MediumCardiologyHeart failure with reduced ejection fractionau-amcau-racp
A 72-year-old man with a history of ischaemic cardiomyopathy (LVEF 30%) presents for routine review. He is on perindopril, bisoprolol and spironolactone at target doses. His BP is 110/70 mmHg, pulse 64 bpm, NYHA class II, euvolaemic on examination. His eGFR is 55 mL/min/1.73 m² and potassium 4.6 mmol/L. According to current heart failure management strategies, what is the most appropriate additional therapy to improve prognosis?