الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
MI is caused by an imbalance between myocardial blood demand and the coronary blood delivery that leads death of myocardium and then mechanical, electrical, structural, and biochemical changes of the cardiac muscle. Acute MI is a leading cause of morbidity and mortality of CVD in developed as well as in developing countries. In Egypt, the prevalence of IHD is 8.3%. Oxidative stress is a leading cause in the development of MI. It stems from an imbalance between oxidative radicals and anti-oxidant enzymes. Moreover, TGFβ that is a multifunctional cytokine appeared to play a vital role in the pathogenesis of MI. It promotes the secretion of numerous proteins of the extracellular matrix including collagens, fibronectin and proteoglycans. Additionally, it promotes myocyte apoptosis, reduction of myocyte proliferation thus, increases infarction size and causes cardiac fibrosis and scar formation if not treated properly. So, searching for protective agents becomes an urgent need.The PDE5i ,Sil, is a widely used medication for treatment of erectile dysfunction and pulmonary arterial hypertension. It also, decreases platelet aggregation and the risk of obesity complications. However, its prophylactic role against MI still a matter of debate and controversy. So, we aimed to illustrate this issue.Vit. E is a fat-soluble, it is incorporated into cell membranes, which are therefore protected from oxidative damage. It’s is the most abundant and important lipophilic radical-scavenging antioxidant in vivo . It acts as the first line of defense against lipid peroxidation, protecting the cell membranes from free radical attack. It is characterized by being safe, effective, easy obtained, cheap and a vital vitamin for good health . So, we aimed to declare its prophylactic impact on MI.