title: Earlobe crease shapes and cardiovascular events.
abstract: Earlobe crease (ELC) has been linked to coronary artery disease; however, systematic evaluations of the earlobe and its relation to ischemic stroke are lacking. The objectives were to define the ELC using a single-blind approach and to determine through multivariate analysis its association with cardiovascular events (CVEs) comprising coronary, ischemic cerebrovascular, and peripheral vascular diseases. A single-blind cross-sectional study was performed in 2 phases: (1) an initial study (n = 300) to define ELC classification criteria and (2) a confirmation stage (n = 1,000) to analyze ELC association with CVEs. Each of the participants' pinnae were photographed and classified blindly by joint decision according to ELC's inclination, length, depth, and bilateralism. Patients' medical histories were reviewed for age, cardiovascular risk factors, and CVEs. The concordance rate after the classification of all photographs was 89.6%. The first phase did not find any correlation between the different depth degrees or vertical creases and CVEs. The second stage concluded that diagonal bilateral ELC prevalence in patients with CVEs was 43% compared with 29% in the control patients (p <0.001). The multivariate analysis showed an association between ELC and CVEs (odds ratio 1.45, 95% confidence interval [CI] 1.08 to 1.93, p = 0.012), with a sensitivity and specificity of 43% and 70%, respectively. Ischemic stroke alone was also associated with diagonal bilateral ELC (odds ratio 1.67, 95% confidence interval 1.1 to 2.51, p = 0.015). In conclusion, diagonal bilateral ELC is independently associated with CVEs in the hospitalized population. An independent association with ischemic stroke has also been demonstrated for the first time.
authors.affiliation: Department of Preventive Medicine, Public Health and Microbiology of the School of Medicine of the Universidad Autonoma de Madrid, Spain.
authors.forename: Claudia
authors.initials: C
authors.lastname: Rodríguez-López
authors.affiliation: Department of Preventive Medicine, Public Health and Microbiology of the School of Medicine of the Universidad Autonoma de Madrid, Spain.
authors.forename: Hugo
authors.initials: H
authors.lastname: Garlito-Díaz
authors.affiliation: Department of Preventive Medicine, Public Health and Microbiology of the School of Medicine of the Universidad Autonoma de Madrid, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Madroñero-Mariscal
authors.affiliation: Department of Preventive Medicine, Public Health and Microbiology of the School of Medicine of the Universidad Autonoma de Madrid, Spain.
authors.forename: Pablo Jesús
authors.initials: PJ
authors.lastname: Sánchez-Cervilla
authors.affiliation: Department of Preventive Medicine, Public Health and Microbiology of the School of Medicine of the Universidad Autonoma de Madrid, Spain.
authors.forename: Auxiliadora
authors.initials: A
authors.lastname: Graciani
authors.affiliation: Department of Cardiology, IDIPAZ, Hospital Universitario La Paz, Madrid, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: López-Sendón
authors.affiliation: Department of Cardiology, IDIPAZ, Hospital Universitario La Paz, Madrid, Spain. Electronic address: e.lopezdesa@terra.com.
authors.forename: Esteban
authors.initials: E
authors.lastname: López-de-Sá
mesh_terms: D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D054644:Ear Auricle / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology