Background: Coronary artery disease is a complex, multifactorial disorder in which various factors are involved and atherosclerosis is a kind of chronic inflammatory disease. In Astherosclerotic plaque there are many changes consistent with a chronic inflammatory process. Tumor necrosis factor-慣(TNF-慣) is a proinflammatory cytokine produced in astherosclerotic plaque that plays an important role in the pathophysiology of the cardiovascular process and may contribute to the progression of atheroma. Method: We investigated whether the polymorphisms in the gene encoding tumor necrosis factor-慣(TNF-慣) had merit as predictive factor of ischemic heart disease. We examined 197 patients previously performed coronary artery stent insertion and genotyped for the G/A polymorphisms at position -238 and the C/T polymorphisms at position -857 and the C/A polymorphisms at position -863 in the promoter region of TNF-慣 gene by polymerase chain reaction and sequencing analysis. Results: The frequency of G/A genotype at position -238 in the promoter region of TNF-慣 gene was statistically significantly higher in ischemic heart disease in comparison with control group(p = 0.030). But polymorphisms at position -857 and -863 in the promoter region of TNF-慣 gene were not significantly associated with ischemic heart disease. We speculate that the -238/G���A SNP of TNF-慣 may promote atheroma progression and precipitate ischemic heart disease. (Table) Conclusion: This study shows that G/A genotype at position -238 in promoter region of TNF-慣 may contribute to role as predictive factor of ischemic heart disease.