TNF-α is a multifunctional circulating cytokine derived from endothelial and smooth muscle cells as well as macrophages associated with coronary atheroma.26,27 TNF-α possesses cytotoxic and negative inotropic actions, aggravates the inflammatory process, and plays a role in neutrophil pre-activation and ischaemic injury.28,29 Brunetti et al.30 reported that levels of TNF-α in patients with acute coronary syndrome were associated with a worse prognosis at follow up. The gene discussed is TNF; the disease is acute coronary syndrome.