Table 2:

Guideline recommendations and level of evidence for therapies shown to improve mortality

Medication Class	Recommendation	Recommendation Class/Level of Evidence	Guidelines
Beta-Blockers	Recommended for all patients with current or prior symptoms of HFrEF	Class I; LOE: A	2013 ACCF/AHA Heart Failure Guideline
ACE-Inhibitors	Recommended in all patients with HFrEF and current or prior symptoms	Class I; LOE: A	2013 ACCF/AHA Heart Failure Guideline 2017 ACC/AHA/HFSA Heart Failure Focused Update
Angiotensin Receptor Blockers	Recommended in patients with HFrEF with current or prior symptoms who are intolerant to ACE-inhibitor	Class I; LOE: A	2013 ACCF/AHA Heart Failure Guideline 2017 ACC/AHA/HFSA Heart Failure Focused Update
Mineralocorticoid Receptor Antagonists	Recommended for all patients with NYHA Class II-IV heart failure with LVEF ≤ 35%. Patients with NYHA Class II should have a history of prior heart failure hospitalization or elevated BNP prior to initiation	Class I; LOE: A	2013 ACCF/AHA Heart Failure Guideline
Angiotensin Receptor Neprilysin Inhibitor	Recommended in selected patients with chronic HFrEF in conjunction with beta-blockers and aldosterone antagonists	Class I; LOE: B	2017 ACC/AHA/HFSA Heart Failure Focused Update

ACE-inhibitors = Angiotensin Converting Enzyme Inhibitors; LOE = Level of Evidence; ACCF = American College of Cardiology Foundation; AHA = American Heart Association; HFSA = Heart Failure Society of America; NYHA = New York Heart Association; LVEF = Left Ventricular Ejection Fraction; HFrEF = Heart Failure with Reduced Ejection Fraction