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Diagonal earlobe crease and long-term survival after myocardial infarction
Christian Thilo1, Christine Meisinger2,3, Margit Heier4,5
1Medizinische Klinik, Romed Klinikum Rosenheim, Rosenheim, Germany.
Insights
Diagonal earlobe crease (DEC) presence indicates a higher risk of death in acute myocardial infarction (AMI) patients. DEC is independently linked to 1-year AMI survival, highlighting its prognostic value.
Area of Science:
- Cardiology
- Dermatology
- Public Health
Background:
- The association between diagonal earlobe crease (DEC) and coronary artery disease is established.
- However, its impact on mortality risk in patients experiencing acute myocardial infarction (AMI) remains unclear.
Purpose of the Study:
- To investigate the relationship between the presence and severity of DEC and mortality in patients with AMI.
- To determine if DEC is an independent predictor of short-term survival post-AMI.
Main Methods:
- A cohort of 655 AMI patients was recruited from the KORA Myocardial Infarction Registry Augsburg (2015-2016).
- DEC severity was assessed from earlobe photographs and dichotomized (grade 2/3 vs. 0/1).
- Cox proportional hazards models were used to analyze the association between DEC and all-cause mortality up to 2019.
Main Results:
- Out of 655 participants, 442 (67.5%) had DEC grade 2/3 and 213 (32.5%) had DEC grade 0/1.
- Patients with DEC grade 2/3 exhibited a higher mortality rate (20.8%) compared to those with DEC grade 0/1 (12.2%).
- A significant 2.57-fold increased hazard ratio for 1-year mortality was observed in patients with DEC grade 2/3 (p=0.0347).
Conclusions:
- Diagonal earlobe crease (DEC) is independently associated with 1-year survival following acute myocardial infarction (AMI).
- DEC serves as a potential prognostic marker for short-term outcomes in AMI patients.
Background:
The association between the presence of a diagonal earlobe crease (DEC) and coronary artery disease has been prescribed earlier. However, it is unclear whether patients with acute myocardial infarction (AMI) and DEC have a higher risk of dying.
Methods:
Study participants were persons with AMI who were included in the KORA Myocardial Infarction Registry Augsburg from August 2015 to December 2016. After taking pictures of both earlobes, two employees independently assessed the severity of DEC in 4°. For analysis, the expression of the DEC was dichotomized. Information on risk factors, severity and therapy of the AMI was collected by interview and from the medical record. Vital status post AMI was obtained by population registries in 2019. The relationship between DEC and survival time was determined using Cox proportional hazards models.
Results:
Out of 655 participants, 442 (67.5%) showed DEC grade 2/3 and 213 (32.5%) DEC grade 0/1. Median observation period was 3.06 years (5-1577 days). During this period, 26 patients (12.2%) with DEC grade 0/1 and 92 patients (20.8%) with grade 2/3 died (hazard ratio 1.91, 95% confidence interval (CI) 1.23-2.96, p = 0.0037). In the fully adjusted model, patients with DEC grade 2/3 had a 1.48-fold increased risk of death compared to the DEC grade 0/1 patient group (CI 0.94-2.34, p = 0.0897). The fully adjusted model applied for 1-year survival revealed a significant, 2.57-fold hazard ratio of death (CI 1.07-6.17, p = 0.0347) for the patients with DEC grade 2/3.
Conclusions:
Our results indicate that DEC is independently associated with 1-year AMI survival.
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