MediumCardiologyHeart failure with reduced ejection fractionau-amcau-racp
A 68-year-old man with symptomatic heart failure with reduced ejection fraction (LVEF 30%) is on maximally tolerated perindopril and bisoprolol. He remains NYHA class III with peripheral oedema despite optimised diuretics. His potassium is 4.4 mmol/L and eGFR is 55 mL/min/1.73 m². What is the most appropriate additional disease-modifying therapy?