Abstract
Objectives
The association between diagonal ear lobe crease (DELC) and
cardiovascular disease was first suggested in 1973 although some studies
have attributed this to confounding cardiovascular factors. This review
looked to see if there is a significant association between the presence
of a DELC and angiography-confirmed coronary artery disease (CAD)
independent of other risk factors.
Design
Systematic review and meta-analysis of selected studies using the PRISMA
checklist.
Setting
12 different hospitals with angiography in eight different countries
Participants
4960 adult patients undergoing coronary angiography.
Main Outcome Measures
- Presence / absence of diagonal ear lobe crease
- Diagnostic Odds Ratio
- Sensitivity / Specificity
Results
12 studies were included in the meta-analysis. Findings from our study
suggest:
- Patients with DELC have a 4x increased likelihood of having CAD (OR
4.61 P<0.00001).
- The relationship between DELC and CAD was independent of age and all
other conventional cardiovascular risk factors.
- Bilateral DELC has a stronger association with CAD than unilateral
DELC.
- Presence of DELC has insufficient sensitivity / specificity to be used
as a diagnostic test for cardiovascular disease but instead should be
used as a risk marker.
Conclusions
We found that DELC is associated with CAD independently of other known
cardiovascular risk factors including age. Histology studies indicate
that atherosclerosis is causing DELC and patients with DELC appear to
have an increased risk of CAD. It has insufficient sensitivity or
specificity to be used as a diagnostic test but should be used as a
valuable risk marker to be aware of whilst examining ears.