TNF and acute coronary syndrome: In a Swedish study, 2 years follow-up on TNFi was associated with a 32% reduction in the risk of acute coronary syndrome: HR 0.78 (95% CI 0.61 to 1.01).29 There is a biologically plausible explanation for our findings as TNFα plays a key role in the pathogenesis of atherosclerosis.30 Inflammation is central in all stages of atherosclerosis, including endothelial function, plaque stabilisation and postinfarct remodelling, and thus inhibition of TNFα may influence accumulation and progression of plaque leading to fewer MIs.