Ear lobe crease: a marker of coronary artery disease?

Agouridis, Aris P.; Elisaf, Moses; Nair, Devaki; Mikhailidis, Dimitri P.

doi:10.5114/aoms.2015.56340

Cited by 31 publications

(30 citation statements)

References 100 publications

(140 reference statements)

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“…These findings have been corroborated in subsequent studies, providing a robust epidemiological association between ELC and coronary artery disease [4, 13]. However, other studies have cast doubts on the strength of this association [14]. The same has occurred with studies attempting to assess the association between the ELC and other markers of atherosclerosis, including peripheral artery disease [15, 16].…”

Section: Discussionmentioning

confidence: 72%

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

Brutto

Mera

Costa

et al. 2019

Heliyon

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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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Section: Discussionmentioning

confidence: 72%

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

Brutto

Mera

Costa

et al. 2019

Heliyon

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“…4 As far as the diagonal ELC is concerned, it seems that its prevalence increases with advancing age. 4 Of note, ELC is absent at birth and usually appears later in life. 4 As a result, early or late development may refine the clinical value of the aforementioned signs.…”

Section: Discussionmentioning

confidence: 99%

“…4 Of note, ELC is absent at birth and usually appears later in life. 4 As a result, early or late development may refine the clinical value of the aforementioned signs. After taking the above into consideration, we cannot say with confidence that ATC and ELC represent markers of CAD.…”

Section: Discussionmentioning

confidence: 99%

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Anterior Tragal Crease: A Marker of Coronary Artery Disease

Agouridis

2020

Angiology

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The prevalence of cardiovascular (CV) disease (CVD), comprising coronary artery disease (CAD), heart failure, stroke, and hypertension in adults 20 years of age is 48.0% overall and increases with age in both males and females. 1 Coronary artery disease (43.2%) is the leading cause of CVD death in the United States, followed by stroke (16.9%), hypertension (9.8%), and heart failure (9.3%). 1 Total CAD prevalence is 6.7% in US adults 20 years of age (7.4% for males and 6.2% for females). 1 It is estimated that by 2030, 40.5% of the US population will have some form of CVD. 2 Traditional CV risk factors include age, hypertension, dyslipidemia, diabetes, smoking, obesity, as well as family history of premature coronary heart disease. Other CVD risk predictors include certain inflammatory and hemostatic markers, endothelial dysfunction, homocysteine, microalbuminuria/proteinuria, coronary artery calcium score, arterial stiffness, inflammatory bowel syndrome, obstructive sleep apnea, impaired glucose metabolism, metabolic syndrome as well as nonalcoholic fatty liver disease. 3 Changes in ear crease have been suggested as potential markers of CAD in numerous studies. 4 These ear crease changes, such as diagonal ear lobe crease (ELC) and anterior tragal crease (ATC) are simple clinical signs easily recognized by general practitioners. This makes ATC and ELC promising signs, in combination with the above risk factors, to identify patients at risk of developing clinical atherosclerosis.

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“…As stated earlier, if patients with ELCs are at higher risks of CVD than those without ELCs, those with ELCs would also be at higher risk of mortality, which would decrease their prevalence. Second, although the mechanisms leading to the concurrent development of ELC and CVD are uncertain , substantial differences in risk factors for CVD between individuals undergoing hemodialysis and the general population may have affected this association. While some traditional risk factors in the general population, such as obesity and high serum cholesterol concentrations, are not especially relevant for individuals undergoing hemodialysis, non‐traditional risk factors specific to ESKD patients, such as disturbed mineral–bone homeostasis, uremic toxins, anemia, oxidative stress, and protein energy wasting, are strongly relevant to these individuals .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Earlobe Creases and Their Association With History of Cardiovascular Disease in Patients Undergoing Hemodialysis: A Cross‐Sectional Study

et al. 2017

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Earlobe creases are surrogate markers for high risk of cardiovascular disease. There is no data concerning earlobe creases among hemodialysis patients, who have an increased risk of cardiovascular disease. A cross-sectional study was conducted to determine the prevalence of earlobe creases and their association with prevalent cardiovascular disease among hemodialysis patients. Patients undergoing hemodialysis were recruited from five outpatient hemodialysis centers. Both earlobes were photographed during a dialysis session with the patient in a supine position and the photos evaluated independently by two experienced nephrologists blinded to the participants' clinical characteristics. Prevalent cardiovascular diseases were defined as a history of myocardial infarction, cerebrovascular accident, or peripheral vascular disease. Sensitivity, specificity, and positive and negative predictive values for detection of prevalent cardiovascular disease were calculated. Logistic analysis was used to examine the association between earlobe creases and prevalent cardiovascular disease. Earlobe creases were identified in 24.5% of 330 hemodialysis patients (200 men; mean age, 67.8 years). The prevalence of earlobe creases increased with age for men (P for trend <0.0001), but not for women (P for trend = 0.07). Sensitivity, specificity, and positive and negative predictive values were 30.9% (95% confidence interval, 21.9-41.6), 77.5% (71.9-82.3), 30.9% (21.9-41.6), and 77.5% (71.9-82.3), respectively. Multivariate logistic analyses indicated the prevalence of earlobe crease was not associated with prevalent cardiovascular diseases. The prevalence is similar to that previously reported for Japanese individuals not undergoing dialysis. No association between earlobe creases and prevalent cardiovascular diseases was identified.

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Ear lobe crease: a marker of coronary artery disease?

Cited by 31 publications

References 100 publications

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

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

Anterior Tragal Crease: A Marker of Coronary Artery Disease

Prevalence of Earlobe Creases and Their Association With History of Cardiovascular Disease in Patients Undergoing Hemodialysis: A Cross‐Sectional Study

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