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Open Access Highly Accessed Research article

Diagonal earlobe crease and coronary artery disease in a Chinese population

Xing-li Wu1*, Ding-you Yang2, Yu-sheng Zhao1, Wen-hui Chai3 and Ming-lei Jin4

Author Affiliations

1 Institute of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, China

2 Department of Traditional Chinese Medicine, the First Affiliate Hospital of Chinese PLA General Hospital, Beijing, China

3 Department of Geriatrics, the Changji People’s Hospital, Urumqi, China

4 Department of Geriatrics, Chengde City People’s Hospital, Hebei, China

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BMC Cardiovascular Disorders 2014, 14:43  doi:10.1186/1471-2261-14-43

Published: 4 April 2014



Many reports have claimed associations between diagonal earlobe crease (DELC) and coronary artery disease (CAD), but data in Chinese populations are limited.


This cohort study investigated 449 consecutive Chinese, 250 cases with CAD and 199 without CAD, who were certified by coronary artery angiography in our center. Characteristic differences and the relation of DELC to CAD were assessed by Chi-square and t tests. The multivariate regression was performed to adjust for confounders and ROCs mode were used to detect its predicting performance for CAD.


The prevalence of DELC was 46.2% in those without CAD and 75.2% in those with CAD (P < .001). Subjects with DELC had more stenostic vessels and higher prevalence of both any and significant coronary artery stenosis than those without DELC (P < .001). The sensitivity, specificity and positive and negative predictive values for DELC to diagnose CAD in the whole population were 0.752, 0.538, 0.671 and 0.633. The higher sensitivity and positive predictive values (ppv) were found in male, the lowest sensitivity and the highest ppv in the <45 years old group, and the lowest specificity and ppv in the >75 years old group. After adjusting for other variables including age, gender and traditional risk factors, DELC remained a positive predictor for CAD (OR, 3.408; 95% CI 2.235-5.196; P < 0.001), but not for hypertension, diabetes mellitus, hypercholesterolemia and hypertriglyceridemia. ROC analysis showed the area under the curve was 0.645 (95% CI 0.593-0.697, p < 0.001).


The study showed a significant association between DELC and CAD independent of established risk factors in Chinese.

Diagonal earlobe crease; Coronary artery disease; Chinese ethnics; Coronary artery angiography; Han Chinese