Anterior Tragal Crease Is Associated With Atherosclerosis: A Study Evaluating Carotid Artery Intima–Media Thickness

Abstract

The utility of the ear crease sign, anterior tragal crease (ATC), as a marker of atherosclerosis is yet to be established. The intima-media thickness of the common carotid artery (IMT-CCA) has been used as a noninvasive surrogate marker for atherosclerosis. History of traditional risk factors for atherosclerosis was obtained from 147 volunteers; ear examination was also performed and venous blood was drawn for laboratory analysis. The volunteers then underwent an ultrasonography measurement of the IMT-CCA. In univariate analysis, presence of ATC, age, underlying hypertension, diabetes mellitus, ischemic heart disease, cerebrovascular disease, cigarette smoking, low-density lipoprotein, and high-sensitivity C-reactive protein were significantly associated with the IMT-CCA. Further multivariate analysis confirmed a significant association between the presence of ATC and IMT-CCA, when adjusted for other factors (adjusted β = .010, 95% confidence interval: 0.0021-0.019). Anterior tragal crease is a potential clinical sign that can predict atherosclerosis. The sign is easily recognizable and may help health-care professionals to identify those at risk of atherosclerosis, especially in people with no clinical signs of the disease.

The Association between Earlobe Crease (Frank’s Sign) and Abnormal Ankle-Brachial Index Determination Is Related to Age: A Population-Based Study

“…However, others believe that ELC may be an unrelated bystander [ 4 ]. ELC has also been associated with increased carotid artery intima-media thickness and arterial stiffness [ 5 ]. These findings have opened new venues for the use of ELC for identifying apparently healthy individuals at risk of developing vascular events.…”

On the association between earlobe crease and the carotid intima-media thickness: A population-based study

“…Most of the studies trying to demonstrate an association between ELC and cIMT disclosed an apparent association between both variables [5, 6, 7, 8, 9]. However, the aforementioned studies were flawed by either biased selection of participants, a small sample size, limited assessment of the cIMT to a single artery wall, and different cutoffs used for defining an increased cIMT (Table 2).…”

“…It is also possible that the ELC might be genetically determined, which might explain its different correlates with atherosclerosis according to race/ethnicity [4]. Information on the association between ELC and the carotid intima-media thickness (cIMT) – a surrogate of extracranial atherosclerosis – is limited [5, 6, 7, 8, 9]. Using the Atahualpa Project cohort, we aimed to assess this association in community-dwelling adults.…”

Anterior Tragal Crease Is Associated With SYNTAX Score in Non-ST-Segment Elevation Myocardial Infarction

“…16 It is hypothesized that the decreased activity of macrophages is responsible for the development of DEL and atherosclerotic vessels. 17 Anterior tragal crease was reported to be an indicator of atherosclerosis in a study, 18 while it was also linked to peripheral arterial disease (PAD) in another study. 19 The complexity of coronary lesions may be linked to atherosclerotic burden.…”