The utility of earlobe crease for the detection of sub-clinical atherosclerosis.

Abstract

Traditionally a crease in the ear has been considered a visible marker of atherosclerosis. There is strong evidence of its association with coronary heart disease (CHD) revealed in several retrospective and prospective studies. However, the usefulness of the earlobe crease (ELC) as a marker of atherosclerotic diseases of other vascular beds, especially in the intracranial or extracranial carotid vasculature, is not clear. A non-systematic search of studies evaluating the association between ELC and atherosclerosis was performed. Observational studies that explored the association of ELC with atherosclerosis in many vascular beds were reviewed. Most studies presented methodological limitations, selection bias, and relatively small sample sizes. Discrepancies were found between studies, mainly due to the interaction of age in the association pathway. In a population cohort study, age was the main modifier of the effect of ELC with atherosclerosis in different vascular beds. The role of ELC as a marker of atherosclerosis remains unclear, at least for extra-coronary atherosclerosis.