Clinical Value of the Diagonal Earlobe Crease in Patients with Chest Pain for Diagnosing Coronary Heart Disease

Jie Gao; Jie Dou; Hui-Hui Yang; Ruo-Ling Guo; Chao Jiang; Gary Tse; Tong Liu; Jian-Wei Liu; Dong-Lei Luo

doi:10.2147/IJGM.S454888

Clinical Value of the Diagonal Earlobe Crease in Patients with Chest Pain for Diagnosing Coronary Heart Disease

Int J Gen Med. 2024 Apr 23:17:1557-1569. doi: 10.2147/IJGM.S454888. eCollection 2024.

Authors

Jie Gao^#¹, Jie Dou^#¹, Hui-Hui Yang¹, Ruo-Ling Guo¹, Chao Jiang¹, Gary Tse^{2

3

4}, Tong Liu², Jian-Wei Liu⁵, Dong-Lei Luo⁶

Affiliations

¹ Chengde Medical University, Chengde, 067000, People's Republic of China.
² Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, 300211, People's Republic of China.
³ School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, 999077, People's Republic of China.
⁴ Epidemiology Research Unit, Cardiovascular Analytics Group, PowerHealth Limited, Hong Kong, 999077, People's Republic of China.
⁵ Department of Cardiothoracic Interventional Vascular Surgery, Chengde Central Hospital/Second Clinical College of Chengde Medical University, Chengde, Hebei, 067000, People's Republic of China.
⁶ Department of Cardiology, Chengde Central Hospital / Second Clinical College of Chengde Medical University, Chengde, 067000, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: To investigate the clinical application value of diagonal earlobe crease (DELC) in patients with chest pain for the diagnosis of coronary heart disease (CHD) and to construct a risk model by multivariate logistic regression.

Patients and methods: Our trial enrolled prospectively and consecutively 706 chest pain patients with suspected CHD between January 2021 to June 2023 from Chengde Central Hospital. According to coronary angiography results, they were categorized into the CHD (n=457) and non-CHD groups (n=249).

Results: The trial demonstrated a significant positive relationship between DELC and CHD. Independent risk factors were sex, age, hypertension, diabetes mellitus, LP (a), Cys C, and DELC, whilst HDL-C was a protective factor, for CHD. Patients with-DELC were older than those in the without-DELC arm (P<0.001) and had a higher proportion of males than females (61.6% vs 50.0%, P=0.026). After multifactorial correction, independent risk factors for CHD included DELC (OR=1.660, 95% CI:1.153 to 2.388, P=0.006), age (OR=1.024, 95% CI:1.002 to 1.045, P=0.030), gender (OR=1.702, 95% CI:1.141 to 2.539, P=0.009), hypertension (OR=1.744, 95% CI:1.226 to 2.482, P=0.002), diabetes mellitus (OR=2.113, 95% CI:1.404 to 3.179, P<0.001), LP(a) (OR=1.010, 95% CI:1.003 to 1.017, P=0.005), Cys C (OR=3.549, 95% CI:1.605 to 7.846, P=0.002). The Hosmer and Lemeshow (H-L) test (P=0.818) suggests a high goodness of fit, and the area under the ROC curve was calculated to be 0.721 (95% CI:0.682 to 0.760, P<0.001), which demonstrates that the model has a superior diagnostic value for CHD.

Conclusion: DELC is an independent risk factor for CHD after adjusting for sex, age, hypertension, diabetes mellitus, smoking index, LP (a), Cys C, and HDL-C. Our model can be used clinically for assessing the risk of CHD.

Keywords: coronary angiography; coronary heart disease; diagonal earlobe crease; model.

Grants and funding

This study was funded by the Medical Science Research Project of Hebei Province (NO. 20200348, 20200236), the S&T Program of Chengde (NO. 202109A019), the Project of Chengde Central Hospital (NO. YJKT20220001) and Hebei Province Master’s Graduate Innovation Ability Training Funding Project (NO. CXZZSS2023147).