Arterial endothelium and atherothrombogenesis II--the role of endothelial dysfunction in atherothrombotic lesions.

When cardiovascular risk factors prevail, the endothelial phenotype evolves to a dysfunctional state that is characterized by decreased endothelial-dependent vasodilation and the expression of proinflammatory, procoagulant, pro-oxidant and proliferation signals. Together, these alterations cause perfusion anomalies, promote the development and progression of atherosclerosis, and lead to atherosclerotic cardiovascular events. There is evidence that endothelial dysfunction is a predictor and prognostic risk factor of cardiovascular events, and characterization of the state of endothelial function in all susceptible individuals is strongly recommended as a preventive measure against atherosclerotic disease and to guide and monitor antiatherogenic treatment and atherosclerotic complications.