A 68-year-old man with NYHA class II heart failure with reduced ejection fraction (LVEF 32%) is on maximally tolerated ACE inhibitor, beta blocker, mi...

Question

A 68-year-old man with NYHA class II heart failure with reduced ejection fraction (LVEF 32%) is on maximally tolerated ACE inhibitor, beta blocker, mineralocorticoid receptor antagonist and diuretic. He remains symptomatic and has type 2 diabetes with eGFR 55 mL/min/1.73 m². According to CCS heart failure guidelines, which additional medication class should be added to reduce hospitalisations and mortality?

Accepted Answer

SGLT2 inhibitor (e.g., dapagliflozin).

Answer

Ivabradine.

Answer

Hydralazine alone.

Answer

Long-acting nitrate alone.

Answer

Non-dihydropyridine calcium channel blocker.

ca-mccqe1 MCQ (SBA): HFrEF optimisation