Frank sign may predict more advanced coronary artery disease in patients admitted with a first time acute coronary syndrome

Abstract

Aim: Diagonal ear lobe crease (DELC), also called as Frank's sign, is a diagonal fold or wrinkle-like line in the skin of the earlobe. This sign detected on the physical examination was proposed as a surrogate marker for individuals at high risk of cardiovascular disease. The aim of our study was to assess the relationship between presence of DELC and the severity of coronary artery disease according to the SYNTAX score in patients with firstly diagnosed acute coronary syndrome (ACS).
 Material and Methods: 356 patients admitted to the emergency department with the diagnosis of ACS from November 2015 to December 2016 were enrolled into the study. Patients were stratified into 3 groups: low SYNTAX score (< 23), high SYNTAX score (≥23) and patients with normal coronary. 
 Results: Patients with DELC as percentage were statistically significantly different between all groups (p < 0.001). Higher number of DELC (OR = 0.497; 95% CI: 0.246-1.001; p = 0.043) was an independent predictor for a high SYNTAX score in the ACS patients after multiple linear regression analysis. 
 Conclusion: Frank’s sign can help primary practitioners to predict severity of CAD.