MediumCardiologyHeart failure with reduced ejection fractionca-mccqe1ca-rcpsc-im
A 59-year-old man with a history of anterior myocardial infarction two years ago has chronic heart failure with reduced ejection fraction (LVEF 30 percent). He remains mildly dyspnoeic with moderate exertion despite maximally tolerated doses of an ACE inhibitor, a beta-blocker, and spironolactone. He has normal renal function and no diabetes. According to contemporary Canadian heart failure guidelines, which additional medication class should be added to reduce mortality and heart failure hospitalisations?