Presence of ear lobe crease may predict intermediate and high-risk patients with acute non-ST elevation acute coronary syndrome.

Muzaffer Kahyaoglu,Ahmet Guner,Yusuf Yilmaz,Ender Ozgun Cakmak,Ibrahim Akin Izgi,Cetin Gecmen,Ahmet Karaduman,Ozkan Candan,Mehmet Celik,Emrah Bayam,Murat Gucun

doi:10.34172/jcvtr.2020.30

Abstract

Introduction: Ear lobe crease (ELC) was first described in 1973 as a physical examination finding indicating significant coronary artery disease (CAD). Several studies have been carried out in relation to this finding, and it has been shown that it is a marker of intima-media thickness, carotid artery disease, and CAD. We aimed to investigate the relationship between earlobe crease, which is a simple physical examination finding, and GRACE score as a risk estimation index in acute coronary syndromes without ST-segment elevation (NSTE-ACS) patients. Methods: 360 patients (mean age 62.2 years, 70% male) were included in our study. Patients were divided into two groups of GRACE scores ≤ 109 and >109, 167 patients were enrolled in group 1, and193 cases in group 2. Results: The group 2 patients were older, had higher systolic blood pressure (SBP) levels, a higher rate of hypertension, higher glucose levels, lower creatinine clearance levels, higher initial and peak troponin levels, lower hemoglobin levels, lower left ventricular ejection fraction (LVEF) and higher Gensini scores than the patients in group 1. The higher GRACE score group had markedly increased frequencies of ELC compared to the lower GRACE score group (80.8% vs. 24.5%, respectively, P < 0.001). Conclusion: The presence of ELC may predict moderate to high risk group of patients with NSTEACS.

Highlights

Ear lobe crease (ELC) was first described in 1973 as a physical examination finding indicating significant coronary artery disease (CAD)
We aimed to examine the interrelation between ELC, which is a simple physical examination finding, and Global Registry of Acute Coronary Events (GRACE) score as a risk estimation index in patients with non-ST segment elevation acute coronary syndrome (NSTE-acute coronary syndromes (ACS))
Kahyaoglu et al according to their GRACE scores as ≤109 and >109. 167 subjects were put in group 1, and 193 cases were put in group 2

Summary

Introduction

Ear lobe crease (ELC) was first described in 1973 as a physical examination finding indicating significant coronary artery disease (CAD). We aimed to investigate the relationship between earlobe crease, which is a simple physical examination finding, and GRACE score as a risk estimation index in acute coronary syndromes without ST-segment elevation (NSTE-ACS) patients. According to 2015 ESC guidelines for ACS without persistent ST segment elevation, it is recommended to use established risk scores for prognosis estimation with Class 1 recommendation.. Several validated risk prediction tools have been identified such as Thrombolysis in Myocardial Infarction (TIMI) risk score, the Global Registry of Acute Coronary Events (GRACE) Risk model, Crusade long-term mortality score, CHADS2 score and ACTION registry score, but according to the guidelines, the most commonly used ones are GRACE and TIMI risk scores.. Based on the clinical trials performed, risk factors that could benefit from high risk and early invasive treatment have been determined and identified. Several validated risk prediction tools have been identified such as Thrombolysis in Myocardial Infarction (TIMI) risk score, the Global Registry of Acute Coronary Events (GRACE) Risk model, Crusade long-term mortality score, CHADS2 score and ACTION registry score, but according to the guidelines, the most commonly used ones are GRACE and TIMI risk scores. GRACE risk score is a detailed standard risk scoring system used for early diagnosis, risk classification, prognosis and treatment of ACS, and this risk score predicts the risks of hospital mortality and sixmonth mortality for all patients with ACS.

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