TNFα appears to limit infarct size by preventing or delaying apoptosis of cardiac myocytes and may have a homeostatic role in limiting the amount and duration of damage after an ischaemic insult.17 Conversely, neutralising TNFα with antibodies has been shown to reduce infarct size in murine models.18 The outcome of MI in patients with RA receiving TNFi therapy has not previously been studied. Here, TNF is linked to rheumatoid arthritis.