Meyer Noah¹, Bauer Elias², Keller Anna³, Schubert Finn⁴, Herrmann Lina⁵, Böhm Lukas⁶, Günther Marie⁷, Scholz Leon⁸, Winkler Amelie⁹
ABSTRACT:
Endothelial dysfunction (ED) is a pivotal early event in atherosclerosis, driving plaque initiation, progression, and destabilization. This review examines biomarkers reflecting ED, including nitric oxide (NO) bioavailability, adhesion molecules, microparticles, and oxidative stress markers, and their role in predicting atherosclerotic cardiovascular disease (ASCVD). Clinical and translational studies highlight the utility of these biomarkers in identifying high-risk patients, monitoring therapy, and guiding personalized interventions. Challenges such as assay standardization, dynamic variability, and integration into clinical workflows are discussed. Future directions focus on omics-driven discoveries, AI-enhanced risk models, and point-of-care technologies for global implementation.