MSFinals-0217

A 60-year-old man presents to cardiology outpatients after being lost to follow-up for 2 years. He has a significant cardiac history, including two previous myocardial infarctions, peripheral vascular disease, and three transient ischemic attacks. He is also a non-insulin-dependent diabetic. Upon examination, his JVP is raised by 2 cm, he has peripheral pitting edema to the mid-calf bilaterally, and bilateral basal fine inspiratory crepitations. His last ECHO, which was conducted 3 years ago, showed moderately impaired LV function and mitral regurgitation. He is currently taking bisoprolol, aspirin, simvastatin, furosemide, ramipril, and gliclazide. What medication could be added to improve his prognosis?