Earlobe crease and coronary heart disease in Japanese

Summary

To evaluate whether a significant statistical correlation exists between earlobe crease (EC) and coronary heart disease (CHD), 1000 Japanese adult patients (573 males, 427 females) were examined for the presence or absence of EC, clinical or angiographic evidence of CHD, and the following coronary risk factors: male sex, age over 50 years, obesity, hypertension, diabetes mellitus, cigarette smoking, and hyperlipidemia. Patients were divided into two groups according to clinical evidence of CHD: (1) 237 patients with angina pectoris and/or myocardial infarction (CHD+ group); (2) 720 patients without evidence of CHD (CHD− group). Coronary angiography was performed on 200 patients from this sample population; these patients were also divided into two groups: (1) 119 patients with greater than 50% luminal narrowing of at least one major coronary artery (stenosis+ group); (2) 81 patients with no significant atherosclerotic changes in the coronary arteries (stenosis− group).

EC was present in 58 of 237 CHD+ patients (24.5%) but in only 35 of 720 CHD− patients (4.8%;P<0.001); it was present in 31 of 199 stenosis+ patients (26.1%) but in only 3 of 81 stenosis− patients (3.7%;P<0.01). EC was also found to correlate significantly with some coronary risk factors; the correlations between the presence of EC and the presence of CHD and coronary risk factors were investigated by multivariate analysis. In a multivariate setting, the existence of CHD and an age of over 50 years was significantly related to the presence of EC. To investigate the relationship between EC and advancing age, all patients were separated into age-groups. In each decade of life, the analysis showed a statistically significant association between EC and CHD; it is thus considered that the association of EC with CHD is independent of the patient's age. It is concluded that: (1) the prevalence of EC in Japanese adults is very low compared with the results of previous studies in Europe and America; (2) the prevalence of EC tends to increase with advancing age but is unrelated to other risk factors for CHD; (3) a statistically significant association between EC and CHD is seen from multivariate analysis using both clinical and angiographic criteria in the diagnosis of CHD.