MediumCardiologyHeart failure with reduced ejection fractionau-amcau-racp
A 72-year-old woman with a history of ischaemic cardiomyopathy (left ventricular ejection fraction 30 percent) and NYHA class II symptoms is reviewed in clinic. She is on perindopril, bisoprolol and frusemide. Her blood pressure is 118/70 mmHg, potassium is 4.6 mmol/L and eGFR is 65 mL/min/1.73 m². According to heart failure guidelines, which additional medication has the greatest prognostic benefit at this stage?