HardCardiologyHeart failure with reduced ejection fractionca-rcpsc-im
A 70-year-old man with ischaemic cardiomyopathy (left ventricular ejection fraction 30%) remains NYHA class II despite optimal doses of an ACE inhibitor, a beta blocker and spironolactone. He has type 2 diabetes and an eGFR of 55 mL/min/1.73 m². According to Canadian heart failure guidelines, which additional medication class has been shown to reduce heart failure hospitalisation and cardiovascular death?