Title:
The Role of Tumor Necrosis Factor-alpha as a Marker of Inflammation and a Predictor of in-hospital Complications in Patients with Acute Coronary Syndrome

Authors:
Sally Abdul-Raheem Alhumrani, Nidham M. Jamalludeen*, Abdulameer Abdulbari Abdulhameed**, Iraq

Abstract:

Background
Acute coronary syndromes are caused by rupture of plaques or erosion that leads to local clotting formation of coronary blood flow eventually blocking to necrosis or ischemia of myocardial cells. Prognosis; other markers of inflammation may play similar role. Cytokines are responsible for modulating immune and inflammatory processes as well as both proliferative and apoptotic responses. Tumor necrosis factor (TNF-α): It is an important cytokine involved in systemic inflammation. This study aimed to measure TNF-α level and its association with hospital complications in patients with the acute coronary syndrome.
Method:
One hundred and twenty-five patients with acute coronary syndrome and 120 healthy individuals as a control group
According to ECG and serum troponin changes, the patient group was classified into three; ST-elevated myocardial infarction, ST non-elevated myocardial infarction and unstable angina.
Sandwich ELISA was used by commercial groups (LEGAND MAXTM) for the TNF-α assay.
Result:
This study shows highly significant differences in the level of TNF-αin patient with acute coronary syndrome (27.49) as compared with the control group (10.62) (P. value 0.001)
There were no statistically significant differences in the level of TNF-α in patients with acute coronary syndrome and some traditional risk factors like gender (P. value 0.25).
There were statistically significant differences in the level of TNF-α in all forms of ACS and control group p-value 0.001
 Patients with in hospital complication had higher level of TNF-α (33.46 Pg\dl) than those without complication (24.15 Pg\dl) P-value (0.041).
Conclusion:
This study indicated that TNF-α was significantly elevated in patients with ACS and maybe a good predictor not only of acute coronary event but also disease severity and prognosis for complications.

DOI: http://dx.doi.org/10.51505/ijmshr.2021.5112