NPPB and heart failure: A metanalysis published in 2015 concluded that cTnT, hs-cTnT, BNP, NT-proBNP, and D-dimers do suffer serum level changes when a person is performing a high-intensity physical effort, which may interfere with their interpretation in an emergency unit when an acute coronary syndrome, heart failure or pulmonary embolism can be suspected [55].