Conclusion
This review looked to see if there is a significant association between
the presence of a diagonal ear lobe crease (DELC) and coronary artery
disease (CAD). We found that DELC is associated with CAD independently
of other known cardiovascular risk factors including age and that
patients with DELC appear to have an increased risk of CAD (OR 4.61) and
this may be higher for patients with bilateral DELC. The variety of
groups included in the selected studies suggest that this finding is
relevant to the wider population. The sign does not have sufficient
specificity or sensitivity to be used as a diagnostic test but instead
it should be considered as a risk marker. For this reason we believe it
is an important quick sign for clinicians to be aware of particularly
those who more frequently examine ears. Histology studies have also
indicated a feasible mechanism for atherosclerosis to cause DELC and
explain this finding.