TNF and infection: These infections can trigger local or systemic inflammatory conditions, due to bacterial products and their endotoxins (LPS) when released into the bloodstream, stimulating the production of cytokines such as tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β), and subsequently leading to endothelial dysfunction and atherogenesis, especially in elderly patients above 65 years of age with an increased risk of cardiac disease [44,45,46,47].