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Tumor Necrosis Factor Alpha In Patients With Acute Myocardial Infarction

1Maged Ramses Fahim, 2Sherine Maher Halim and 2Iman Kamel

1National Heart Institute Imbaba, Giza and 2Department of Clinical pathology, Elmatarya Teaching Hospital, Cairo, Egypt.

Acute myocardial infarction (AMI) is a myocardial necrosis occurring due to persistent coronary ischemia, in which inflammation plays an important role and heart failure is a common complication. The present work was undertaken to clarify the role of Tumor Necrosis Factor Alpha (TNF-a) in acute myocardial infarction (AMI). The study was conducted on 20 newly diagnosed AMI patients and 10 healthy age and sex matched controls. Sequential estimation of plasma TNF a level was carried out at admission, 24 and 48 hours post admission using ELISA. AMI patients showed a significant increase of plasma TNF-a level on admission, and 24 hours post admission but not after 48 hours. However, a significant increase was still seen at 48 hours post admission in patients with signs of heart failure but not in those without signs of heart failure. A significant positive correlation was found between plasma TNF-a level and CPK level at admission. on the other hand a significant negative correlation was found between these 2 parameters at 24 and 48 hours post admission. It is concluded that TNF -a may be an early marker of myocardial damage because of the early increase of its level after ischemic injury instead of being late consequence of extensive tissue necrosis. TNF-a level may be an important indicator of the severity of AMI and the occurrence of heart failure.