TNF and coronary artery disorder: Inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α), can promote VSMC apoptosis by inducing programmed cell death through the activation of caspases, a family of enzymes that facilitate cell suicide.[66] Additionally, chronic oxidative stress represents the second most detrimental factor contributing to VSMC apoptosis in CHD.[67] One of the critical pathways mediating VSMC apoptosis is the intrinsic apoptotic pathway, which is regulated by mitochondrial dysfunction.