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Initiation and optimisation of the Four Pillars of Heart Failure. All agents are initiated in parallel. This is followed by up-titration in one, two or three steps, as required. Additional therapies are then considered as a final step. ARNI, angiotensin receptor-neprilysin inhibitors; BB, beta-blocker; MRA, mineralocorticoid receptor antagonists;SGLT2i, sodium-glucose co-transporter 2inhibitors.
