Association of the cutaneous markers with coronary artery disease : a case control study

Objectives: To determine the strength of the association of the cutaneous markers described in coronary artery disease (CAD). Methods: A hospital-based, case-control study was conducted in Christian Medical College, Vellore for the period of 14 months from September 2012 to October 2013. Two hundred patients were recruited from the cardiology in-patients who underwent coronary angiogram.Cases were 153 patients with CAD and controls, 47 without CAD on the basis of coronary angiogram.Patients were examined for the presence of androgenetic alopecia (AGA), acanthosis nigricans (AN), diagonal earlobe crease (DELC), preauricular crease (PAC), corneal arcus (CA), thoracic hairs, acrochordons, premature canities (PC), xanthelasma and xanthomas. A record of the history of onset, morphology, grading and distribution of the lesions was made. Results: DELC (diagnostic odds ratio 811.62, sensitivity98.69, specicity91.49), PAC (diagnostic odds ratio97.63, sensitivity67.97%, specicity-97.87%), AGA (diagnostic odds ratio 21.76, sensitivity95.42%, specicity51.06%), PC (diagnostic odds ratio4.45, sensitivity47.71%, specicity82.98%), AN (diagnostic odds ratio4.01, sensitivity41.18%, specicity85.11%), thoracic hairs (diagnostic odds ratio – 130.76, sensitivity92.02%, specicity91.89%), corneal arcus (diagnostic odds ratio 24.61, sensitivity86.93%, specicity78.72%) and ear canal hairs (diagnostic odds ratio-22.21, sensitivity49.67%, specicity95.74%) were found to be associated with CAD. But xanthelasma palpebrarum (diagnostic odds ratio 0.50) and acrochordons (diagnostic odds ratio1.13) were not associated with CAD. Multiple logistic regression analysis showed DELC and thoracic hairs were strongly associated with CAD. Conclusion: The study suggests that diagonal ear lobe crease, preauricular crease, androgenetic alopecia, premature canities, acanthosis nigricans, thoracic hairs, corneal arcus and ear canal hairs are associated with coronary artery disease while xanthelasma palpebrarum and acrochordons are not. Key WordsCutaneous manifestations, Coronary artery disease, Thoracic hairs 1 1 1 1 Rahul Kumar Sharma , Susanne Pulimood , Dincy Peter , Leni George Department Of Dermatology, Christian Medical College, Vellore Corresponding Author: Dr. Rahul Kumar Sharma Consultant dermatologist, Ajmer Email: consultantdermatologistmd@gmail.com ASSOCIATION OF THE CUTANEOUS MARKERS WITH CORONARY ARTERY DISEASE: A CASE CONTROL STUDY