NPPB and myocardial ischemia: Brain natriuretic peptide (BNP) and N-terminal brain natriuretic peptide precursor (NT-proBNP) are widely used by clinicians to assess the presence and severity of heart failure, but their specificity is low and elevated BNP levels can also result from conditions like left or right heart failure, total heart failure, pneumonia, myocardial ischemia, and renal failure (7, 8).