TNF and myocardial ischemia: Thus, in this systematic review and meta-analysis, we explored randomized controlled trials (RCTs) aiming to assess L-arginine impact on myocardial stress, considering myocardial cytokines (interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α)) and myocardial ischemia, indicated by troponin T concentration and creatine phosphokinase-MB (CPK-MB) levels, specifically among patients who underwent CABG surgery.