Which medication class is not known to reduce mortality in heart failure with reduced EF?

Which medication class is not known to reduce mortality in heart failure with reduced EF?

• A. Beta-blockers
• B. RAAS inhibitors
• C. Calcium channel blockers
• D. Aldosterone antagonists

Answer: (C)

In heart failure with reduced ejection fraction, improving survival comes from therapies that blunt detrimental neurohormonal activation and remodeling. Beta-blockers, RAAS inhibitors (ACE inhibitors/ARBs), and aldosterone antagonists have solid trial evidence showing mortality reduction. Calcium channel blockers, on the other hand, do not confer a survival benefit in this setting. They can worsen contractility in a failing heart, and trials with agents like amlodipine and felodipine showed no mortality improvement, with some non-dihydropyridine CCBs causing negative inotropy. So the medication class not known to reduce mortality in HFrEF is calcium channel blockers.

In heart failure with reduced ejection fraction, improving survival comes from therapies that blunt detrimental neurohormonal activation and remodeling. Beta-blockers, RAAS inhibitors (ACE inhibitors/ARBs), and aldosterone antagonists have solid trial evidence showing mortality reduction. Calcium channel blockers, on the other hand, do not confer a survival benefit in this setting. They can worsen contractility in a failing heart, and trials with agents like amlodipine and felodipine showed no mortality improvement, with some non-dihydropyridine CCBs causing negative inotropy. So the medication class not known to reduce mortality in HFrEF is calcium channel blockers.