ArticleBMJ open2016
Relationship between diagonal earlobe creases and coronary artery disease as determined via angiography.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Diagonal earlobe crease (Frank's sign) and increased risk of cerebrovascular diseases: review of the literature and implications for clinical practice.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2020Pooled it
- Exploration of oral microbiota alteration and AI-driven non-invasive hyperspectral imaging for CAD prediction.BMC cardiovascular disorders · 2025Article
- Advancements in Frank's sign Identification using deep learning on 3D brain MRI.Scientific reports · 2025Article
- Predictive value of atherogenic index of plasma in combination with diagonal earlobe crease in coronary heart disease.Frontiers in cardiovascular medicine · 2025Article
- Prevalence of Frank's sign in healthy young individuals, morphological characteristics, and its association with family history of chronic disease.Forensic science, medicine, and pathology · 2024Article
- Relationship between Earlobe Crease and Anatomical Severity of Coronary Artery Disease in ST-segment Elevation Myocardial Infarction.Internal medicine (Tokyo, Japan) · 2024Article
- Traditional Cardiovascular Risk Factors Associated with Diagonal Earlobe Crease (Frank Sign) in Mexican Adults: Aging, Obesity, Arterial Hypertension, and Being Male Are the Most Important.International journal of hypertension · 2024Article
- Clinical Value of the Diagonal Earlobe Crease in Patients with Chest Pain for Diagnosing Coronary Heart Disease.International journal of general medicine · 2024Article
- The relationship of diagonal earlobe crease (Frank's sign) and obstructive coronary artery disease in patients undergoing coronary angiography.Wiener klinische Wochenschrift · 2023Article
- The prognostic value of deep earlobe creases in patients with acute ischemic stroke.Frontiers in cardiovascular medicine · 2023Article
- What do Steven Spielberg, Mel Gibson and Emperor Hadrian have in common? Frank's sign and the link with coronary artery disease.Oxford medical case reports · 2021Article
- Diagonal Earlobe Crease (Frank's Sign) for Diagnosis of Coronary Artery Disease: A Systematic Review of Diagnostic Test Accuracy Studies.Journal of clinical medicine · 2021Review
- Adropin and Irisin Deficiencies Are Associated With Presence of Diagonal Earlobe Crease in CAD Patients.Frontiers in cardiovascular medicine · 2021Article
- Association Between Androgenic Alopecia and Coronary Artery Disease: A Cross-Sectional Study of Han Chinese Male Population.International journal of general medicine · 2021Article
- Patients with Earlobe Crease May Associate with Lower Concentration of the Age-Suppressing Hormone Klotho.International journal of general medicine · 2021Article
- Prevalence of the Frank's sign by aetiopathogenic stroke subtype: A prospective analysis.PloS one · 2021Article
- Ear Crease Features Are Associated with Complexity of Coronary Lesions.Medical science monitor : international medical journal of experimental and clinical research · 2020Observational
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Corrections and comments
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study was designed to examine the prevalence of unilateral and bilateral diagonal earlobe creases (DELCs) with respect to the diagnosis of coronary heart disease (CHD).
methodsA total of 558 consecutive participants (402 males and 156 females) aged 36-91 years who underwent coronary angiography were enrolled in this study. The participants were classified as being without a DELC, having a unilateral DELC and having bilateral DELCs; participants with either a unilateral DELC or bilateral DELCs were defined as participants with DELCs. Significant CHD was defined as at least one major vessel with >50% stenosis, and coronary atherosclerosis severity was defined using the Gensini scoring system.
resultsIn the present study, bilateral DELCs were more frequently among male (p=0.001), CHD (p=0.000), older people (p=0.000) and those with more severe coronary artery atherosclerosis (p=0.000). The results of the multiple regression analyses indicated that DELCs (OR, 4.861; 95% CI 3.093 to 7.642, p=0.000) remained independently associated with a risk of CHD. It was assumed that participants without a DELC have a certain background risk for CHD (OR is assumed to be 1); the results of the multivariate logistic regression indicated that the relative risk of CHD among participants with bilateral DELCs was 5.690 among all participants (OR, 5.690; 95% CI 3.450 to 9.384, p=0.000), 5.436 among male participants (OR, 5.436; 95% CI 2.808 to 10.523, p=0.000) and 7.148 among female participants (OR, 7.148; 95% CI 3.184 to 16.049, p=0.000). Moreover, a positive association between DELC and age (SI=1.21, SIM=1.65, AP =0.132), gender (SI=2.09, SIM=0.81, AP=0.49) and smoking status (SI=1.49, SIM=0.73, AP=0.29) was found, respectively.
conclusionsThe results of the present study indicated that DELCs are a simple and a feasible means of identifying CHD. However, the exact mechanism underlying the relationship between DELCs and CHD warrants further study.
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