Further Developments

Transthoracic echocardiography shows a left ventricular ejection fraction of 35%. Dr. McPhee reviews the results with Mr. Green and explains that these findings are consistent with heart failure. Mr. Green’s HbA1c is 8.2%. He arranges follow‑up with cardiology for guideline‑directed medical therapy and with endocrinology to coordinate diabetes management. Dr McPhee reinforces daily medication adherence and regular follow-ups.

At the cardiology visit, the cardiologist explains that, over the next few weeks, several medications will be started and titrated to treat Mr Green’s heart failure. He adds that one of the new drugs will also be beneficial for Mr. Green’s type 2 diabetes and has been shown to have positive effects on cardiovascular outcomes.

Which medication is the most appropriate choice that benefits both heart failure and type 2 diabetes for Mr. Green?