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Natriuretic Peptides and Mortality in Community-Acquired PneumoniaNatriuretic Peptides and Pneumonia Mortality FREE TO VIEW

Catherina L. Chang, MD; Robert J. Hancox, MD
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From the Department of Respiratory Medicine, Waikato Hospital.

Correspondence to: Catherina L. Chang, MD, Department of Respiratory Medicine, Waikato Hospital, Hamilton, 3204, New Zealand; e-mail: contact_cat@hotmail.com

Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(1):264. doi:10.1378/chest.12-0392
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Published online

To the Editor:

We read with great interest the study by Nowak et al1 in a recent issue of CHEST (April 2012) on natriuretic peptides in patients with community-acquired pneumonia. The findings extend two earlier reports on the prognostic significance of these peptides by the same group.2,3 It would be helpful to know to what extent these cohorts overlapped. In particular, the two most recent studies recruited patients with community-acquired pneumonia admitted to the same hospital between 2003 and 2005. The most recent publication1 extended the recruitment period to include April 2006 to March 2007, but it is not clear whether some patients were in both cohorts or how many new patients were added in the extra recruitment time for the recent study.

If there is overlap between these two cohorts, we would also be grateful if the authors could clarify two further points. First, the initial cohort was part of a randomized controlled trial where patients were managed empirically or according to serial procalcitonin levels,4 whereas the current report states that all patients were managed according to standard guidelines. Secondly, Nowak et al1 state that the treating clinicians were blinded to natriuretic peptide levels, whereas the earlier report stated that B-type natriuretic peptide levels were available to the treating clinicians and may, therefore, have influenced treatment. We would be grateful if the authors could clarify these issues because we believe that it would help us to interpret the findings.

Nowak A, Breidthardt T, Christ-Crain M, et al. Direct comparison of three natriuretic peptides for prediction of short- and long-term mortality in patients with community-acquired pneumonia. Chest. 2012;141(4):974-982. [PubMed] [CrossRef]
 
Christ-Crain M, Breidthardt T, Stolz D, et al. Use of B-type natriuretic peptide in the risk stratification of community-acquired pneumonia. J Intern Med. 2008;264(2):166-176.
 
Müeller C, Laule-Kilian K, Scholer A, Perruchoud AP. B-type natriuretic peptide for risk stratification in community-acquired pneumonia. J Intern Med. 2005;258(4):391-393.
 
Christ-Crain M, Stolz D, Bingisser R, et al. Procalcitonin guidance of antibiotic therapy in community-acquired pneumonia: a randomized trial. Am J Respir Crit Care Med. 2006;174(1):84-93.
 

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References

Nowak A, Breidthardt T, Christ-Crain M, et al. Direct comparison of three natriuretic peptides for prediction of short- and long-term mortality in patients with community-acquired pneumonia. Chest. 2012;141(4):974-982. [PubMed] [CrossRef]
 
Christ-Crain M, Breidthardt T, Stolz D, et al. Use of B-type natriuretic peptide in the risk stratification of community-acquired pneumonia. J Intern Med. 2008;264(2):166-176.
 
Müeller C, Laule-Kilian K, Scholer A, Perruchoud AP. B-type natriuretic peptide for risk stratification in community-acquired pneumonia. J Intern Med. 2005;258(4):391-393.
 
Christ-Crain M, Stolz D, Bingisser R, et al. Procalcitonin guidance of antibiotic therapy in community-acquired pneumonia: a randomized trial. Am J Respir Crit Care Med. 2006;174(1):84-93.
 
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