An up-to-date review on guideline directed medical therapies that aim to improve prognosis in HFrEF patients. Research on medical interventions that may improve prognosis in patients with chronic heart failure has had great success in the past decades. Therefore, there are well- established classes of drugs – ACEi, beta- blockers, MRAs – that should be used as first line treatment in all patients with heart failure. In the past few years newer therapeutic approaches have been shown to improve

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... ognosis in patients with heart failure but, since the evidence generated by these newer classes of drugs is less than that of the first three classes of drugs these therapies should be implemented only after an initial treatment with the first line drugs has been implemented. This article reviews the advances that have achieved in the treatment of heart failure in terms of a prognostic benefit.