MediumCardiologyHeart failure with reduced ejection fractionca-mccqe1ca-rcpsc-im
A 60-year-old man with ischaemic cardiomyopathy (LVEF 28%) remains mildly symptomatic with NYHA class II dyspnoea despite optimised doses of an ACE inhibitor, beta-blocker and mineralocorticoid receptor antagonist. Blood pressure is 118/70 mm Hg, eGFR 70 mL/min/1.73 m² and potassium 4.5 mmol/L. What is the next evidence-based addition to his pharmacotherapy according to CCS heart failure guidance?