Tumor necrosis factor alpha as a parameter used in assessing patients with acute myocardial infarction with and without acute left sided heart failure

ABSTRACT

To clarify the use of tumor necrosis factor alpha in the course and prognosis of acute myocardial infarction and its relation to development of left sided heart failure following myocardial infarction. This case-control study was conducted on 30 persons, 20 of them were newly diagnosed as acute myocardial infarction [AMI] [group A] and 10 healthy age and sex-matched served as controls [group B]. All subjects [patients and controls] were subjected to full medical history and family history of coronary heart disease, thorough clinical examination, chest X-ray post- anterior [PA] and lateral, electrocardiography [ECG], measurement of cardiac enzymes [CPK, SGOT, LDH, CBC, CRP and ESR], estimation of plasma TNF alpha for both patients and controls by ELISA. AMI patients [group A] had a highly significant increase of serum TNF alpha level on admission, especially with those with signs of heart failure, significant increase of its level at 24 hours and insignificant increase of its level at 48 hours compared to healthy control [group B]. There was a significant positive correlation between TNF alpha and CPK level on admission in AM1 patients. There was a significant negative correlation between them at 24 and 48 hours