title: Diagonal earlobe crease as a marker of the presence and extent of coronary atherosclerosis.
abstract: This study evaluates the association between the presence of diagonal earlobe creases (ELC) and coronary artery disease (CAD). One thousand four hundred twenty-four patients (760 men and 664 women, aged 30 to 80 years) were examined for the presence of ELC and classified into 2 groups: group I control--1,086 consecutive patients who denied symptoms of myocardial ischemia and were admitted to a general hospital for other reasons; group II CAD--338 patients with documented CAD (presence of > or = 70% coronary diameter stenosis at angiography). ELC was present in 304 patients (28%) in group I and 220 (65%) in group II (p < 0.0001). The patients were stratified in age groups to isolate the influence of age because the prevalence of ELC and CAD increased with advancing age (p < 0.0001 for both). This association remained statistically significant in all decades, except for patients aged > 70 years. To further remove the confounding effect of different age and sex distributions between the groups, a direct adjustment of the ELC prevalence was performed. When adjusted for age and sex, the prevalence of creases was still 58% higher in patients with CAD than in control subjects (p < 0.001). The presence of ELC was also related to the extent of CAD as measured by the number of major arteries narrowed (p = 0.015). The observed sensitivity of the sign for the diagnosis of CAD was 65%, the specificity 72%, the positive predictive value 42% and the negative predictive value 87%.
authors.affiliation: Instituto do Coração, InCor, University of São Paulo, Brazil.
authors.forename: B
authors.initials: B
authors.lastname: Tranchesi Júnior
authors.forename: V
authors.initials: V
authors.lastname: Barbosa
authors.forename: C P
authors.initials: CP
authors.lastname: de Albuquerque
authors.forename: B
authors.initials: B
authors.lastname: Caramelli
authors.forename: O
authors.initials: O
authors.lastname: Gebara
authors.forename: R D
authors.initials: RD
authors.lastname: Santos Filho
authors.forename: O
authors.initials: O
authors.lastname: Nakano
authors.forename: G
authors.initials: G
authors.lastname: Bellotti
authors.forename: F
authors.initials: F
authors.lastname: Pileggi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology; D004431:Ear, External / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012737:Sex Factors
chemical_list: D015415:Biomarkers