MediumCardiologyHeart failure with reduced ejection fractionca-mccqe1ca-rcpsc-im
A 58-year-old man with ischaemic cardiomyopathy (LVEF 30%) remains dyspnoeic on exertion despite optimised doses of an ACE inhibitor, evidence-based beta blocker and mineralocorticoid receptor antagonist. His blood pressure is 112/70 mm Hg, and his eGFR is 55 mL/min/1.73 m². According to Canadian heart failure guidelines, which additional medication class should be added to reduce cardiovascular death and hospitalisation?