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HardCardiologyHeart failure with reduced ejection fractionau-amcau-racp

A 68-year-old Aboriginal man from a remote community with known heart failure with reduced ejection fraction (EF 30%) presents with progressive dyspnoea, orthopnoea and bilateral ankle oedema. He is on perindopril and frusemide. Blood pressure is 110/70 mmHg and heart rate 80 bpm. Creatinine is 110 µmol/L and potassium 4.6 mmol/L. Which additional class of medication is now recommended as part of quadruple therapy to reduce mortality and hospitalisation?

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