TNF and hydrops fetalis: In the ATTACH (Anti-TNF Therapy Against Congestive Heart failure) trial, investigating infliximab, another TNF-α inhibitor, in patients with stable NYHA class III-IV HF and an LVEF ≤ 35%, subjects receiving infliximab had a higher rate of death from any cause or HHF, raising concerns about the use of TNF-α inhibitors in HF [123].