Coronary artery disease is the leading cause of morbidity and mortality worldwide.
The most common pathophysiologic substrate is atherosclerosis which is an inflammatory
procedure that starts at childhood and develops throughout life. Endothelial dysfunction is associated
with the initiation and progression of atherosclerosis and is characterized by the
impaired production of nitric oxide. In general, endothelial dysfunction is linked to poor cardiovascular
prognosis and different methods, both invasive and non-invasive, have been developed
for its evaluation. Ultrasound evaluation of flow mediated dilatation of the branchial
artery is the most commonly used method to assessed endothelial function while intracoronary
administration of vasoactive agents may be also be used to test directly endothelial properties
of the coronary vasculature. Endothelial dysfunction has also been the subject of therapeutic
interventions. This review article summarizes the knowledge about evaluation of endothelial
function in acute coronary syndromes and stable coronary artery disease and demonstrates
the current therapeutic approaches against endothelial dysfunction.