HardCardiologyHeart failure with reduced ejection fractionca-rcpsc-im
A 66-year-old man with ischaemic cardiomyopathy (LVEF 30%) has NYHA class II symptoms despite 6 months of maximally tolerated ramipril, bisoprolol, spironolactone and dapagliflozin. Blood pressure is 118/70 mmHg, creatinine 95 µmol/L and potassium 4.5 mmol/L. According to the latest Canadian heart failure guidelines, which additional change is most appropriate to further reduce his risk of hospitalisation and death?