BACKGROUND: The presence of a Frank’s sign ear crease is closely correlated with coronary artery disease (CAD). The SYNTAX score indicates the complexity of coronary lesions. This present investigation sought to identify the correlation between SYNTAX score and several specific ear creases.

MATERIAL AND METHODS: Four specific types of ear creases – crossing crease not originated from ear hole (CC-NEH), crossing crease originated from ear hole (CC-EH), vertical creases on the face side (VC-F), and vertical creases dividing earlobe and face (VC-EF) – were investigated in patients undergoing coronary angiography. A Frank’s sign score system was introduced based on the 4 creases. Demographic data, clinical data, and SYNTAX score were also documented. The association between ear creases and SYNTAX score, as well as the correlation between Frank’s score and SYNTAX score, were statistically analyzed.

RESULTS: CC-NEH had the highest positive predictive value (positive predictive value=0.439), and VC-F had the highest negative predictive value for the detection of intermediate and high SYNTAX score (negative predictive value=1.000). VC-EF and CC-NEH were associated with intermediate and high SYNTAX scores (OR=2.913–7.694, all P<0.05). Only 2.9% of patients with Frank’s score=0 had intermediate or high SYNTAX scores, and 52.2% and 50.0% of patients with Frank’s sign score=3 and 4 had intermediate or high SYNTAX scores, respectively. The Frank’s sign score was significantly and positively correlated with SYNTAX score (r=0.457, P<0.001).

CONCLUSIONS: Features of specific ear creases and Frank’s sign scores were associated with intermediate and high complexity of coronary lesions.

Keywords: Coronary Artery Disease, Coronary Stenosis, Myocardial Ischemia, Aged, 80 and over, Coronary Angiography, Cross-Sectional Studies, Ear, Logistic Models, Sensitivity and Specificity, young adult