what are the Recommendations for Mineralocorticoid Receptor Antagonists (MRAs)
Referenced studies that support the recommendations are summa-
rized in the Online Data Supplements.?
In patients with HFrEF and NYHA class II to IV symptoms, an MRA (spironolactone or eplere- none) is recommended to reduce morbidity and mortality, if eGFR is >30 mL/min/1.73 m2 and serum potassium is <5.0 mEq/L. Careful moni- toring of potassium, renal function, and diuretic dosing should be performed at initiation and closely monitored thereafter to minimize risk of hyperkalemia and renal insufficiency.