ArticleWiener klinische Wochenschrift2023
The relationship of diagonal earlobe crease (Frank's sign) and obstructive coronary artery disease in patients undergoing coronary angiography.
Article in Wiener klinische Wochenschrift, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 3 citations in OpenAlex.
- Clinical characteristics of subclinical carotid atherosclerosis in middle-aged and elderly populations with different glucose metabolism statuses: a cross-sectional study.Frontiers in cardiovascular medicine · 2026Article
- Diagnostic value of the diagonal earlobe crease in combination with lipoprotein(a) in coronary heart disease.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
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7 authors at 2 institutions in 1 country.
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Abstract
backgroundTraditional risk factors for cardiovascular disease (CVD) play an important role in the clinical evaluation of patients with symptoms suggestive of coronary artery disease (CAD). The utility of the diagonal earlobe crease (DELC) in predicting the presence of CAD is controversial. PURPOSE: To investigate the association between DELC, traditional CVD risk factors, and obstructive CAD.
methodsThis prospective study included 1377 patients (mean age 65 ± 10 years, 64% male) who underwent invasive coronary angiography for suspected acute or chronic coronary syndromes. In addition to routine clinical assessment, all patients underwent visual examination of both earlobes for the presence of DELC. All assessments were made by three independent readers, with a majority vote in the case of disagreement. Obstructive CAD was defined by invasive coronary angiography as > 50% stenosis of the left main coronary artery or > 70% stenosis in any other major epicardial coronary artery.
resultsBilateral DELC was observed more frequently in patients with obstructive CAD than in those without it (67% vs. 33%, p = 0.022). In the multivariate logistic regression model, bilateral DELC was independently associated with CAD (odds ratio [OR] 1.36, 95% confidence interval [CI] 1.07-1.74), along with smoking (OR 1.86, 95% CI 1.44-2.38), diabetes mellitus (OR 1.67, 95% CI 1.29-2.15), male sex (OR 2.04, 95% CI 1.61-2.58), and dyslipidemia (OR 1.54, 95% CI 1.12-2.30); however, the diagnostic accuracy of DELC was modest and resembled that of traditional CVD risk factors.
conclusionDespite being independently associated with obstructive CAD, DELC is not a reliable stand-alone clinical marker of CAD due to modest diagnostic accuracy.
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