Abstract

BackgroundThe association between the presence of a diagonal earlobe crease (DEC) and coronary artery disease has been prescribed earlier. However, it is unclear whether patients with acute myocardial infarction (AMI) and DEC have a higher risk of dying.MethodsStudy participants were persons with AMI who were included in the KORA Myocardial Infarction Registry Augsburg from August 2015 to December 2016. After taking pictures of both earlobes, two employees independently assessed the severity of DEC in 4°. For analysis, the expression of the DEC was dichotomized. Information on risk factors, severity and therapy of the AMI was collected by interview and from the medical record. Vital status post AMI was obtained by population registries in 2019. The relationship between DEC and survival time was determined using Cox proportional hazards models.ResultsOut of 655 participants, 442 (67.5%) showed DEC grade 2/3 and 213 (32.5%) DEC grade 0/1. Median observation period was 3.06 years (5–1577 days). During this period, 26 patients (12.2%) with DEC grade 0/1 and 92 patients (20.8%) with grade 2/3 died (hazard ratio 1.91, 95% confidence interval (CI) 1.23–2.96, p = 0.0037). In the fully adjusted model, patients with DEC grade 2/3 had a 1.48-fold increased risk of death compared to the DEC grade 0/1 patient group (CI 0.94–2.34, p = 0.0897). The fully adjusted model applied for 1-year survival revealed a significant, 2.57-fold hazard ratio of death (CI 1.07–6.17, p = 0.0347) for the patients with DEC grade 2/3.ConclusionsOur results indicate that DEC is independently associated with 1-year AMI survival.

Highlights

  • The association between the presence of a diagonal earlobe crease (DEC) and coronary artery disease has been prescribed earlier

  • The study population consisted of patients with acute myocardial infarction (AMI) who were admitted to a hospital in the study region of the KORA Myocardial Infarction Registry

  • The results of the present study showed that the strength of the association between DEC and mortality attenuates with increasing time after the AMI event

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Summary

Introduction

The association between the presence of a diagonal earlobe crease (DEC) and coronary artery disease has been prescribed earlier. It is unclear whether patients with acute myocardial infarction (AMI) and DEC have a higher risk of dying. In addition to classic risk factors, the diagonal earlobe crease (DEC) has been described as an independent indicator for CAD and other vascular diseases [3]. Frank [4] defined DEC as a deep prominent crease in the lobule portion of the auricle. In order to distinguish between different manifestations of DEC, the classification by Patel [5] considered extent and deepness of the crease resulting in 5 grades (see Fig. 1)

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