MediumCardiologyHeart failure with reduced ejection fractionca-mccqe1ca-rcpsc-im
A 68-year-old man with ischaemic cardiomyopathy and an ejection fraction of 30% remains NYHA class II despite maximally tolerated sacubitril-valsartan, bisoprolol and spironolactone. His blood pressure is 118/72 mm Hg and eGFR is 65 mL/min/1.73 m². He is not diabetic. According to contemporary heart failure guidelines, which additional medication class should be prioritised to further improve prognosis?