TNF and major depressive disorder: Patients with depression reported elevated levels of inflammatory markers IL-1, IL-6, and TNF-alpha, which play a major role in the development of atherosclerosis and coronary artery disease [15-18]. Platelet activation through specific receptors, signaling pathways, and degranulation results in tissue inflammation, which can initiate and aggravate thrombotic complications resulting in cardiovascular morbidity [19,20].