Anterior Tragal Crease Is Associated With Atherosclerosis: A Study Evaluating Carotid Artery Intima–Media Thickness

Rerknimitr, Pawinee; Pongpairoj, Korbkarn; Kumtornrat, Chanat; Panchaprateep, Ratchathorn; Hurst, Cameron; Chutinet, Aurauma; Asawanonda, Pravit; Suwanwela, Nijasri C.

doi:10.1177/0003319716685481

Cited by 7 publications

(12 citation statements)

References 26 publications

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“…However, others believe that ELC may be an unrelated bystander [ 4 ]. ELC has also been associated with increased carotid artery intima-media thickness and arterial stiffness [ 5 ]. These findings have opened new venues for the use of ELC for identifying apparently healthy individuals at risk of developing vascular events.…”

Section: Introductionmentioning

confidence: 99%

The Association between Earlobe Crease (Frank’s Sign) and Abnormal Ankle-Brachial Index Determination Is Related to Age: A Population-Based Study

Brutto

Mera

Costa

et al. 2018

International Journal of Vascular Medicine

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Background Information on the association between earlobe crease (ELC) and peripheral artery disease is limited. We assessed this association in community-dwelling older adults. Study Design A total of 294 Atahualpa residents aged ≥60 years were enrolled. ELC were visually identified by two raters. The ankle-brachial index (ABI), used as a surrogate of peripheral artery disease, was categorized using American Heart Association criteria. Using logistic regression and probability models, adjusted for demographics and cardiovascular risk factors, we assessed the relationship between ELC and abnormal ABI determinations, as well as the influence of age on this association. Results ELC was identified in 141 (48%) individuals, and abnormal ABI determination was carried out in 56 (19%). The association between ELC and abnormal ABI was nonsignificant in logistic regression and probability models with individuals stratified according to their median age. Conclusions The association between ELC and abnormal ABI determinations is probably attenuated by the high prevalence of both conditions in older persons. ELC might not be useful for identifying candidates for ABI determination.

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Section: Introductionmentioning

confidence: 99%

The Association between Earlobe Crease (Frank’s Sign) and Abnormal Ankle-Brachial Index Determination Is Related to Age: A Population-Based Study

Brutto

Mera

Costa

et al. 2018

International Journal of Vascular Medicine

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“…Most of the studies trying to demonstrate an association between ELC and cIMT disclosed an apparent association between both variables [5, 6, 7, 8, 9]. However, the aforementioned studies were flawed by either biased selection of participants, a small sample size, limited assessment of the cIMT to a single artery wall, and different cutoffs used for defining an increased cIMT (Table 2).…”

Section: Discussionmentioning

confidence: 99%

“…It is also possible that the ELC might be genetically determined, which might explain its different correlates with atherosclerosis according to race/ethnicity [4]. Information on the association between ELC and the carotid intima-media thickness (cIMT) – a surrogate of extracranial atherosclerosis – is limited [5, 6, 7, 8, 9]. Using the Atahualpa Project cohort, we aimed to assess this association in community-dwelling adults.…”

Section: Introductionmentioning

confidence: 99%

On the association between earlobe crease and the carotid intima-media thickness: A population-based study

Brutto

Mera

Costa

et al. 2019

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The earlobe crease (ELC) has been linked to coronary artery disease, but there is limited information on the association between ELC and extracranial atherosclerosis. Using the Atahualpa Project cohort, we aimed to assess the association between ELC and increased carotid intima-media thickness (cIMT). Atahualpa residents aged ≥40 years underwent visual inspection of both earlobes to evaluate ELC presence, and ultrasound examinations of carotid arteries to calculate the cIMT. The association between both variables was assessed by logistic regression and predictive models, after adjusting for relevant confounders. Mean age of 570 enrolled individuals was 61.5 ± 12.4 years (58% women). ELC was present in 221 (39%) participants. The mean cIMT was 0.85 ± 0.19 mm, with 81 individuals (14%) having an increased cIMT (>1 mm). Univariate logistic regression showed a significant association between ELC presence and increased cIMT (OR: 1.67; 95% C.I.: 1.04–2.69), which disappeared when age (OR: 1.09; 95% C.I.: 0.65–1.85) and other covariables (OR: 1.06; 95% C.I.: 0.62–1.84) were added to the model. Predictive cIMT margins did not differ according to ELC presence or absence, with participants stratified in quartiles of age. This study shows that the effect of the increase in cIMT in subjects with ELC is related to aging.

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“…16 It is hypothesized that the decreased activity of macrophages is responsible for the development of DEL and atherosclerotic vessels. 17 Anterior tragal crease was reported to be an indicator of atherosclerosis in a study, 18 while it was also linked to peripheral arterial disease (PAD) in another study. 19 The complexity of coronary lesions may be linked to atherosclerotic burden.…”

Section: Introductionmentioning

confidence: 99%

Anterior Tragal Crease Is Associated With SYNTAX Score in Non-ST-Segment Elevation Myocardial Infarction

et al. 2020

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The main aim of this study was to investigate the relation between anterior tragal crease (ATC) and coronary artery lesion complexity and severity assessed using the SYNTAX score (SXscore) in patients with non-ST-segment elevation myocardial infarction (NSTEMI). A total of 121 patients with a first-time diagnosis of NSTEMI were consecutively enrolled. ATC was defined as ≥1 crease that was close to the tragus and descended anteriorly. SXscore was calculated using the SXscore algorithm. The SXscore was higher in the ATC-positive group than in the ATC-negative group (11.85 ± 8.20 vs 7.52 ± 6.38, P = .003). In the univariate analysis, hemoglobin (male: 11.7-17.4 g/dL, female: 11.7-16.1 g/dL; P = .006), diabetes mellitus ( P = .031), current smoking ( P = .022), and presence of ATC ( P = .022) were significantly associated with increased SXscore. Multivariate analysis revealed ATC (95% confidence interval [CI]: 1.313-7.800, P = .011), current smoking (95% CI: 2.034-13.893, P = .001), and hemoglobin (95% CI: 0.433-0.822, P = .002) as independent determinants of increased SXscore. Anterior tragal crease is easily detected by physical examination. Presence of ATC in patients with NSTEMI may be a warning signal of complexity and severity of coronary artery disease (CAD).

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Anterior Tragal Crease Is Associated With Atherosclerosis: A Study Evaluating Carotid Artery Intima–Media Thickness

Cited by 7 publications

References 26 publications

The Association between Earlobe Crease (Frank’s Sign) and Abnormal Ankle-Brachial Index Determination Is Related to Age: A Population-Based Study

The Association between Earlobe Crease (Frank’s Sign) and Abnormal Ankle-Brachial Index Determination Is Related to Age: A Population-Based Study

On the association between earlobe crease and the carotid intima-media thickness: A population-based study

Anterior Tragal Crease Is Associated With SYNTAX Score in Non-ST-Segment Elevation Myocardial Infarction

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