A 68-year-old with HFrEF (EF 25%) on ARNI, beta-blocker, SGLT2 inhibitor has K+ 4.8 and eGFR 58. Should an MRA be used?...

Question

A 68-year-old with HFrEF (EF 25%) on ARNI, beta-blocker, SGLT2 inhibitor has K+ 4.8 and eGFR 58. Should an MRA be used?

Accepted Answer

Yes, start spironolactone with monitoring

Answer

No, avoid MRAs if K+ >4.0

Answer

Use eplerenone only if EF >40

Answer

MRAs are contraindicated in all CKD

Answer

Use hydralazine instead

us-abim MCQ (SBA): Heart Failure with Reduced EF