TNF and angina pectoris: In a study involving South Indian patients with CAD (acute myocardial infarction, unstable and stable angina), Rajappa et al. found that the ratios of pro-/anti-inflammatory cytokines in all the study groups increased significantly when patients with unstable angina were compared to other groups.45 Ridker et al. concluded that inflammation plays a major role in the acute coronary syndromes and that TNF-α gene and protein expression persisted in the myocytes over time, which suggests a possible long-term role of this cytokine in vascular remodelling.39