{"id":6378,"date":"2023-02-28T13:43:20","date_gmt":"2023-02-28T12:43:20","guid":{"rendered":"https:\/\/perruchenautomne.eu\/wordpress\/?p=6378"},"modified":"2023-02-28T13:43:20","modified_gmt":"2023-02-28T12:43:20","slug":"reinventons-la-roue","status":"publish","type":"post","link":"https:\/\/perruchenautomne.eu\/wordpress\/2023\/02\/28\/reinventons-la-roue\/","title":{"rendered":"R\u00e9inventons la roue"},"content":{"rendered":"\n<p>Un <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0735109722073144\">article tr\u00e8s mignon<\/a> qui d\u00e9couvre que c&rsquo;est plus facile de trouver un effet b\u00e9n\u00e9fique chez les patients les plus symptomatiques. La clinique, c&rsquo;est important. C&rsquo;est une sous analyse de DELIVER, dapagliflozine dans l&rsquo;insuffisance cardiaque \u00e0 fraction d&rsquo;\u00e9jection pr\u00e9serv\u00e9e. Vous pouvez voir que plus les patients sont symptomatiques plus la gliflozine va avoir un effet b\u00e9n\u00e9fique, en particulier sur les \u00e9v\u00e9nements d&rsquo;insuffisance cardiaque. <\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/perruchenautomne.eu\/wordpress\/wp-content\/uploads\/2023\/02\/1-s2.0-S0735109722073144-gr1.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"741\" height=\"572\" src=\"https:\/\/perruchenautomne.eu\/wordpress\/wp-content\/uploads\/2023\/02\/1-s2.0-S0735109722073144-gr1.jpg\" alt=\"\" class=\"wp-image-6381\" srcset=\"https:\/\/perruchenautomne.eu\/wordpress\/wp-content\/uploads\/2023\/02\/1-s2.0-S0735109722073144-gr1.jpg 741w, https:\/\/perruchenautomne.eu\/wordpress\/wp-content\/uploads\/2023\/02\/1-s2.0-S0735109722073144-gr1-300x232.jpg 300w\" sizes=\"auto, (max-width: 741px) 100vw, 741px\" \/><\/a><\/figure>\n\n\n\n<p>Sur l&rsquo;am\u00e9lioration des sympt\u00f4mes c&rsquo;est pareil, ceux qui b\u00e9n\u00e9ficient le plus du traitement sont ceux qui sont le plus symptomatique et ceci quelque soit le d\u00e9bit de filtration au d\u00e9part.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/perruchenautomne.eu\/wordpress\/wp-content\/uploads\/2023\/02\/1-s2.0-S0735109722073144-fx1.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"778\" height=\"780\" src=\"https:\/\/perruchenautomne.eu\/wordpress\/wp-content\/uploads\/2023\/02\/1-s2.0-S0735109722073144-fx1.jpg\" alt=\"\" class=\"wp-image-6379\" srcset=\"https:\/\/perruchenautomne.eu\/wordpress\/wp-content\/uploads\/2023\/02\/1-s2.0-S0735109722073144-fx1.jpg 778w, https:\/\/perruchenautomne.eu\/wordpress\/wp-content\/uploads\/2023\/02\/1-s2.0-S0735109722073144-fx1-300x300.jpg 300w, https:\/\/perruchenautomne.eu\/wordpress\/wp-content\/uploads\/2023\/02\/1-s2.0-S0735109722073144-fx1-150x150.jpg 150w, https:\/\/perruchenautomne.eu\/wordpress\/wp-content\/uploads\/2023\/02\/1-s2.0-S0735109722073144-fx1-768x770.jpg 768w\" sizes=\"auto, (max-width: 778px) 100vw, 778px\" \/><\/a><\/figure>\n\n\n\n<p>Ceci rappellera, les r\u00e9sultats d&rsquo;<a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2204233\">EMPA-Kidney<\/a>. M\u00eame si la mol\u00e9cule marche de la m\u00eame fa\u00e7on entre les diff\u00e9rents sous groupes de DFG, ce qui est rassurant. Quand on prend comme marqueur de risque de d\u00e9gradation de la fonction r\u00e9nale ou d&rsquo;\u00e9v\u00e9nements CV, l&rsquo;albuminurie, c&rsquo;est bien ceux plus \u00e0 risque de faire un \u00e9v\u00e9nement (les patient avec un RAC>300) qui b\u00e9n\u00e9ficient le plus du traitement. <\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/perruchenautomne.eu\/wordpress\/wp-content\/uploads\/2023\/02\/image-3.png\"><img loading=\"lazy\" decoding=\"async\" width=\"643\" height=\"386\" src=\"https:\/\/perruchenautomne.eu\/wordpress\/wp-content\/uploads\/2023\/02\/image-3.png\" alt=\"\" class=\"wp-image-6383\" srcset=\"https:\/\/perruchenautomne.eu\/wordpress\/wp-content\/uploads\/2023\/02\/image-3.png 643w, https:\/\/perruchenautomne.eu\/wordpress\/wp-content\/uploads\/2023\/02\/image-3-300x180.png 300w\" sizes=\"auto, (max-width: 643px) 100vw, 643px\" \/><\/a><\/figure>\n\n\n\n<p>Plus votre risque d&rsquo;avoir un mauvais pronostic est important, plus une mol\u00e9cule efficace vous fera gagner du temps sans la survenue de l&rsquo;\u00e9v\u00e9nement que vous craignez et inversement quand votre risque est faible, le b\u00e9n\u00e9fice sera plus lent \u00e0 apparaitre et il sera souvent largement mitig\u00e9 par les effets secondaires potentiels du traitement. Voici une des activit\u00e9s importantes du m\u00e9decin dans les maladies chroniques, identifier celui qui aura le plus de b\u00e9n\u00e9fice du traitement avec le moins d&rsquo;effet secondaire.<\/p>\n\n\n\n<p>Et pour finir dans ma r\u00e9invention de la roue, nous r\u00e9sumerons ceci dans une expression, mesurons la balance b\u00e9n\u00e9fice\/risque de nos soins, la base de l&rsquo;EBM.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Un article tr\u00e8s mignon qui d\u00e9couvre que c&rsquo;est plus facile de trouver un effet b\u00e9n\u00e9fique chez les patients les plus symptomatiques. La clinique, c&rsquo;est important. C&rsquo;est une sous analyse de DELIVER, dapagliflozine dans l&rsquo;insuffisance cardiaque \u00e0 fraction d&rsquo;\u00e9jection pr\u00e9serv\u00e9e. Vous &hellip; <a href=\"https:\/\/perruchenautomne.eu\/wordpress\/2023\/02\/28\/reinventons-la-roue\/\">Continuer la lecture <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[13],"tags":[2233,2231,2229,2230,2232,2172],"class_list":["post-6378","post","type-post","status-publish","format-standard","hentry","category-medecine-2","tag-balance-benefice-risque-2","tag-dapagliflozine","tag-deliver","tag-empa-kidney","tag-empagliflozine","tag-gliflozine"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_shortlink":"https:\/\/wp.me\/p1l1zM-1ES","jetpack_sharing_enabled":true,"jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/perruchenautomne.eu\/wordpress\/wp-json\/wp\/v2\/posts\/6378","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/perruchenautomne.eu\/wordpress\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/perruchenautomne.eu\/wordpress\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/perruchenautomne.eu\/wordpress\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/perruchenautomne.eu\/wordpress\/wp-json\/wp\/v2\/comments?post=6378"}],"version-history":[{"count":3,"href":"https:\/\/perruchenautomne.eu\/wordpress\/wp-json\/wp\/v2\/posts\/6378\/revisions"}],"predecessor-version":[{"id":6384,"href":"https:\/\/perruchenautomne.eu\/wordpress\/wp-json\/wp\/v2\/posts\/6378\/revisions\/6384"}],"wp:attachment":[{"href":"https:\/\/perruchenautomne.eu\/wordpress\/wp-json\/wp\/v2\/media?parent=6378"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/perruchenautomne.eu\/wordpress\/wp-json\/wp\/v2\/categories?post=6378"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/perruchenautomne.eu\/wordpress\/wp-json\/wp\/v2\/tags?post=6378"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}