Add sotagliflozin 200 mg once daily and titrate to 400 mg daily, as tolerated. Prior to discharge from the hospital, the addition of which of the following medications to his current regimen would decrease his risk of cardiovascular death and future heart failure hospitalization or urgent visit for heart failure? Sacubitril/valsartan 97/103 mg twice daily.His blood pressure on the day of transition to oral diuretics is 110/70 mmHg, his heart rate is 65 beats per minute, and he required no supplemental oxygen throughout the admission. Relevant labs on the day of transition to oral diuretics include: He is transitioned back to an oral diuretic regimen. After 3 days of diuresis, his symptoms have markedly improved and his weight has returned to baseline. He is diagnosed with acutely decompensated heart failure and started on IV furosemide. Most recent HbA1c of 7.4% when measured 3 months ago.Home medications include carvedilol, spironolactone, and sacubitril/valsartan.CRT-D implanted 2 years prior for primary prevention and a left bundle branch block with a QRS width > 150 ms.Echocardiogram (6 months prior): left ventricular ejection fraction (LVEF) 25%, normal right ventricular function, and no significant valvular dysfunction.Prior medical history includes the following: At the time of admission, his eGFR is 65 mL/min/1.73 m 2 and an N-terminal pro-B-type natriuretic peptide (NT-proBNP) is 1,200 pg/mL. A 65-year-old man with a history of chronic heart failure with reduced ejection fraction (HFrEF) is admitted with exertional shortness of breath, paroxysmal nocturnal dyspnea, bendopnea, and weight gain.
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