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Year : 2020  |  Volume : 9  |  Issue : 2  |  Page : 67-72

Correlation between earlobe crease and coronary artery disease in Indian population- A multicentre experience

1 Department of Cardiology, Super-Speciality Hospital, NSCB Medical College, Jabalpur, India
2 Department of Cardiology, All India Institution of Medical Sciences, Rishikesh, Uttarakhand, India
3 Department of Cardiology, LPS Institution of Cardiology, Kanpur, Uttar Pradesh, India
4 Department of Community Medicine, Medical Sciences, Rishikesh, Uttarakhand, India
5 Department of Cardiology, SS Medical College, Rewa, Madhya Pradesh, India
6 Department of Cardiology, ABVIMS and Dr. RML Hospital, New Delhi, India
7 Department of Community and Family Medicine, All India Institution of Medical Sciences, Rishikesh, Uttarakhand, India
8 Department of Cardiology, Grant Medical College and JJ Group of Hospitals, Mumbai, Maharashtra, India
9 Department of ENT, Dr. BAM Hospital (Central Railways), Mumbai, Maharashtra, India

Correspondence Address:
Dr. Vikas Mishra
Department of Cardiology, Super-Speciality Hospital, NSCB Medical College, Jabalpur, Madhya Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JCPC.JCPC_10_20

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Background: Earlobe crease (ELC) has been found to be associated with the presence of coronary artery disease (CAD) in many studies; however, studies from India are limited. The aim of this study was to determine the prevalence of CAD in those with ELC and to assess the correlation of ELC with severity of CAD. Materials and Methods: This was a cross-sectional, multicenter study; 1400 patients undergoing coronary angiogram were approached, but 1070 patients were analyzed after excluding patients with ear piercings and other ear diseases. Patients were classified into no ELC, mild ELC, and severe ELC according to Ishi et al. Results: Seven hundred and eighty patients had CAD proven by coronary angiography. Of these, 74% (580/780) had an ELC either mild or severe. The patients with ELC had a significantly higher incidence of hypertension, diabetes mellitus, and hypercholesterolemia. However, the prevalence of smoking and family history of premature cardiovascular death were similar in both the groups. The prevalence of CAD was found to be significantly higher (odds ratio [OR]: 4.22 [95% confidence interval (CI): 3.18–5.61], P < 0.0001) among the patients with ELC (580/698) in comparison to patients without ELC (200/372). The prevalence of multivessel disease (MVD) was found to be significantly higher among the ELC-positive patients than ELC-negative patients (OR: 5.03 [95% CI: 3.61–6.90], P < 0.0001). Moreover, MVD was significantly more prevalent in patients (OR: 6.27 [95% CI: 4.23–9.29], P < 0.0001) in the severe ELC group (150/190) in comparison to the mild ELC group (190/508). Conclusion: ELC is an important clinical sign which should be examined carefully for its presence as well as severity. Both presence and severity of crease were related to occurrence and severity of CAD, respectively, in our study. Long-term cohort studies involving multiple ethnicity populations are necessary to determine the role of ELC in development as well as prognosis of CAD.

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