Endothelial dysfunction as a predictor of acute coronary syndromes.

Endothelial dysfunction is a key early event in atherogenesis and is integral in the onset of acute coronary syndromes. Disruption of the normal endothelial functions leads to loss of vasomotor control, reduced production of nitric oxide, formation of a procoagulant surface, and promotion of inflammation. These events may lead to destabilization of atherosclerotic plaques and the onset of acute coronary syndromes. There are several direct and indirect ways of assessing endothelial dysfunction in vivo. Several of these measures of endothelial dysfunction have been shown to correlate with increased risk of adverse cardiovascular outcomes.