» Articles » PMID: 38680192

Clinical Value of the Diagonal Earlobe Crease in Patients with Chest Pain for Diagnosing Coronary Heart Disease

Overview
Journal Int J Gen Med
Publisher Dove Medical Press
Specialty General Medicine
Date 2024 Apr 29
PMID 38680192
Authors
Affiliations
Soon will be listed here.
Abstract

Purpose: To investigate the clinical application value of diagonal earlobe crease (DELC) in patients with chest pain for the diagnosis of coronary heart disease (CHD) and to construct a risk model by multivariate logistic regression.

Patients And Methods: Our trial enrolled prospectively and consecutively 706 chest pain patients with suspected CHD between January 2021 to June 2023 from Chengde Central Hospital. According to coronary angiography results, they were categorized into the CHD (n=457) and non-CHD groups (n=249).

Results: The trial demonstrated a significant positive relationship between DELC and CHD. Independent risk factors were sex, age, hypertension, diabetes mellitus, LP (a), Cys C, and DELC, whilst HDL-C was a protective factor, for CHD. Patients with-DELC were older than those in the without-DELC arm (<0.001) and had a higher proportion of males than females (61.6% vs 50.0%, =0.026). After multifactorial correction, independent risk factors for CHD included DELC (OR=1.660, 95% CI:1.153 to 2.388, =0.006), age (OR=1.024, 95% CI:1.002 to 1.045, =0.030), gender (OR=1.702, 95% CI:1.141 to 2.539, =0.009), hypertension (OR=1.744, 95% CI:1.226 to 2.482, =0.002), diabetes mellitus (OR=2.113, 95% CI:1.404 to 3.179, <0.001), LP(a) (OR=1.010, 95% CI:1.003 to 1.017, =0.005), Cys C (OR=3.549, 95% CI:1.605 to 7.846, =0.002). The Hosmer and Lemeshow (H-L) test (=0.818) suggests a high goodness of fit, and the area under the ROC curve was calculated to be 0.721 (95% CI:0.682 to 0.760, <0.001), which demonstrates that the model has a superior diagnostic value for CHD.

Conclusion: DELC is an independent risk factor for CHD after adjusting for sex, age, hypertension, diabetes mellitus, smoking index, LP (a), Cys C, and HDL-C. Our model can be used clinically for assessing the risk of CHD.

References
1.
Pryor D, Shaw L, McCants C, Lee K, Mark D, Harrell Jr F . Value of the history and physical in identifying patients at increased risk for coronary artery disease. Ann Intern Med. 1993; 118(2):81-90. DOI: 10.7326/0003-4819-118-2-199301150-00001. View

2.
Pacei F, Bersano A, Brigo F, Reggiani S, Nardone R . Diagonal earlobe crease (Frank's sign) and increased risk of cerebrovascular diseases: review of the literature and implications for clinical practice. Neurol Sci. 2019; 41(2):257-262. DOI: 10.1007/s10072-019-04080-2. View

3.
Higuchi Y, Maeda T, Guan J, Oyama J, Sugano M, Makino N . Diagonal earlobe crease are associated with shorter telomere in male Japanese patients with metabolic syndrome. Circ J. 2008; 73(2):274-9. DOI: 10.1253/circj.cj-08-0267. View

4.
Reeh J, Therming C, Heitmann M, Hojberg S, Sorum C, Bech J . Prediction of obstructive coronary artery disease and prognosis in patients with suspected stable angina. Eur Heart J. 2018; 40(18):1426-1435. DOI: 10.1093/eurheartj/ehy806. View

5.
Mancia G, Kreutz R, Brunstrom M, Burnier M, Grassi G, Januszewicz A . 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal.... J Hypertens. 2023; 41(12):1874-2071. DOI: 10.1097/HJH.0000000000003480. View