MediumCardiologyHeart failure with reduced ejection fractionau-racpau-amc
A 68-year-old man with ischaemic cardiomyopathy has an echocardiogram showing a left ventricular ejection fraction of 30%. He is NYHA class II, euvolaemic, and currently takes perindopril and bisoprolol at maximally tolerated doses. His blood pressure is 120/70 mmHg, potassium 4.2 mmol/L and eGFR 65 mL/min/1.73 m². According to heart failure guidelines, which additional drug class is most appropriate to reduce mortality?