Preventing VTE in Outpatients With Cancer.

We thank Drs Chang and Hancox for their interest in our work on natriuretic peptides in community-acquired pneumonia. 1 – 4 The current report 1 extends our previous observations and tries to highlight fi ndings that (1) apply to the whole family of natriuretic peptides in general and (2) provide a direct comparison of the clinical potential of all three commercially available natri uretic pep tides (B-type natriuretic peptide [BNP], N-terminal pro-B-type natriuretic peptide, and midregional pro-atrial natriuretic peptide ). In this analysis, we used the data from all patients who presented to our institution with community-acquired pneu monia in whom we had the measurements of all three natriuretic peptides available. As correctly mentioned by Drs Chang and Hancox, some of these patients were in earlier cohorts that dealt exclusively with BNP. About one-third of the patients were included in the recruitment period from April 2006 to March 2007. Drs Chang and Hancox are also correct in highlighting that in some patients, physicians used procalcitonin levels as additional information for the tailoring of the duration of antibiotic treatment. Regarding blinding, physicians were blinded to N-terminal pro-B-type natriuretic peptide and midregional pro-atrial natriuretic peptide levels in all patients. These levels were measured from frozen samples long after the discharge of patients. The blinding regarding BNP levels was not uniform. In about one-half of the patients, BNP levels were measured in a blinded fashion; in the other half, BNP levels would have been available to physicians via the electronic patient records.