What is recommended for patients with heart failure or myocardial infarction with an LVEF of less than 0.4?
ACE inhibitors and ARBs are recommended for patients with heart failure or myocardial infarction with an LVEF of less than 0.4. Aldosterone blockade is also recommended for patients post MI without significant renal dysfunction or hyperkalemia who are receiving therapeutic doses of ACE inhibitor and beta blocker and have an LVEF of 0.4 or less, diabetes mellitus, or other cardiac or vascular disease (Levels of Evidence: A).