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Morbidity and mortality rates among patients with acute coronary syndrome (ACS) remain high, and it is difficult to determine which patients will progress satisfactorily and which patients will have poor outcomes. Research has indicated that the inflammatory process is involved in coronary disease. There is great interest within the research community in determining if inflammatory markers could be used to determine the severity of the disease process and therefore serve as a prognostic tool for clinicians. This article describes the inflammatory process in ACS and provides a review of the current diagnostic studies of endothelial inflammatory markers (EIMs) in heart disease. Although research results of EIMs have not all been significant in determining outcomes, there is some evidence that they may be more specific than other generalized inflammatory markers, such as C-reactive protein. Future research of EIMs in patients with ACS might provide evidence of easy-to-measure and economically feasible markers that are sound prognosticators.