MediumCardiologyHeart failure with reduced ejection fractionau-racpau-amc
A 68-year-old man with ischaemic cardiomyopathy has an ejection fraction of 30% on echocardiogram. He is NYHA class II despite maximally tolerated doses of perindopril and metoprolol succinate. Blood pressure is 120/70 mmHg, potassium 4.5 mmol/L and eGFR 55 mL/min/1.73 m². Which additional medication is most appropriate to improve survival?