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Relationship between diagonal earlobe creases and coronary artery disease as determined via angiography
  1. Yong Wang1,2,
  2. Li-Hua Mao1,3,
  3. En-Zhi Jia1,
  4. Zhao-Yang Li1,
  5. Xiao-Qing Ding1,
  6. Peng-Cheng Ge1,
  7. Zhe Liu1,
  8. Tie-Bing Zhu1,
  9. Lian-Sheng Wang1,
  10. Chun-Jian Li1,
  11. Wen-Zhu Ma1,
  12. Zhi-Jian Yang1
  1. 1Department of Cardiovascular Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
  2. 2Department of Cardiovascular Medicine, The People's Hospital of Gaochun, Nanjing, Jiangsu Province, China
  3. 3Department of Cardiovascular Medicine, The Jurong City Hospital of Traditional Chinese Medicine, Zhenjiang, Jiangsu Province, China
  1. Correspondence to Dr En-Zhi Jia; enzhijiacn{at}


Objective This study was designed to examine the prevalence of unilateral and bilateral diagonal earlobe creases (DELCs) with respect to the diagnosis of coronary heart disease (CHD).

Methods A total of 558 consecutive participants (402 males and 156 females) aged 36–91 years who underwent coronary angiography were enrolled in this study. The participants were classified as being without a DELC, having a unilateral DELC and having bilateral DELCs; participants with either a unilateral DELC or bilateral DELCs were defined as participants with DELCs. Significant CHD was defined as at least one major vessel with >50% stenosis, and coronary atherosclerosis severity was defined using the Gensini scoring system.

Results In the present study, bilateral DELCs were more frequently among male (p=0.001), CHD (p=0.000), older people (p=0.000) and those with more severe coronary artery atherosclerosis (p=0.000). The results of the multiple regression analyses indicated that DELCs (OR, 4.861; 95% CI 3.093 to 7.642, p=0.000) remained independently associated with a risk of CHD. It was assumed that participants without a DELC have a certain background risk for CHD (OR is assumed to be 1); the results of the multivariate logistic regression indicated that the relative risk of CHD among participants with bilateral DELCs was 5.690 among all participants (OR, 5.690; 95% CI 3.450 to 9.384, p=0.000), 5.436 among male participants (OR, 5.436; 95% CI 2.808 to 10.523, p=0.000) and 7.148 among female participants (OR, 7.148; 95% CI 3.184 to 16.049, p=0.000). Moreover, a positive association between DELC and age (SI=1.21, SIM=1.65, AP =0.132), gender (SI=2.09, SIM=0.81, AP=0.49) and smoking status (SI=1.49, SIM=0.73, AP=0.29) was found, respectively.

Conclusions The results of the present study indicated that DELCs are a simple and a feasible means of identifying CHD. However, the exact mechanism underlying the relationship between DELCs and CHD warrants further study.


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