Earlobe Crease and Coronary Artery Disease

Objectives: Diagonal ear lobe crease (ELC) has been introduced as a diagnostic physical sign for coronary artery disease (CAD) and the aim of this study was to evaluate the association between ELC and CAD in Iranians. Methodology: In a crosssectional study, 106 consecutive patients, referred from cardiologists for angiography, were studied for presence of ELC and CAD in four academic hospitals in Tehran. ELC categorized based on Ishii classification and CAD defined as at least 50% narrowing in one of the three major epicardial vessels. Results: The average age in 70 men and 36 women was 50.14±14.11 years. Based on angiographic results, patients were divided in two groups. In 57 patients of CAD positive group, 34 patients had ELC and in 49 patients of CAD negative group only 13 patients had ELC. (P<0.05) After adjusting for age, ELC was a significant predictor of CAD (P<0.05). The severity of ELC (size and unilateral or bilateral) was significantly related to presence of CAD (P<0.05). The observed sensitivity, specificity, positive predictive value and negative predictive value of ELC for diagnosis of CAD were in the following order: 59.6%, 73.5%, 72.3% and 61% Conclusions: In Iranians, the presence of ELC is associated with CAD.