Evaluation of diagonal earlobe coronary artery disease: the us crease as amarker of of this sign in pre-operative assessment

In this study, we examined the usefulness of the earlobe crease sign as a m arker of coronary artery disease in the pre-operative assessment of patient s. We were interested in evaluating this sign for use in emergency patients . We investigated 530 patients, aged > 40 years, undergoing elective surger y. If the electrocardiogram was abnormal or the patient reported symptoms s uggesting coronary artery disease, further cardiac examinations were perfor med. Patients who demonstrated evidence of coronary artery disease in the a dditional investigations or had a clear history of coronary artery disease were classified as the abnormal coronary group. Other patients with no hist ory and/or normal investigations were classified as the normal coronary gro up. The assessment of earlobe crease sign was performed prior to anaesthesi a, and the sensitivity, specificity and positive predictive value of this s ign were calculated. We found that the sensitivity and specificity was high regardless of age, except for specificity in patients > 70 years old. The data suggest that the earlobe crease sign may be a useful marker for the pr esence of coronary artery disease in patients undergoing emergency operatio ns in which little or no history and investigations are available. However, more work is required to assess the use of this sign in other ethnic group s.