Association of Diagonal Earlobe Crease with Risk of Atrial Fibrillation in Stable Patients with Coronary Artery Disease

<b>Background</b>: Diagonal earlobe crease (DELC) is a proposed visible predictor of coronary artery disease (CAD). However, studies on the association between atrial fibrillation (AF) and DELC are lacking. This study evaluated the association between DELC and the incidence of AF in patients with CAD. <b>Methods</b>: A total of 669 participants aged <65 years (mean, 53.8 ± 7.5 years) diagnosed with CAD and without AF were evaluated for the presence of DELC. The study outcome was the incidence of AF based on the presence of DELC. The study period was planned for 60 months with a minimum follow-up period of 12 months. <b>Results</b>: Herein, the incidence of DELC was 10.8%. During the follow-up period (44.6 ± 14.9 months), the incidences of AF development were 16.4% and 8.4% in DELC and non-DELC groups, respectively. Kaplan-Meier analysis revealed that the occurrence of AF was significantly higher in the DELC group than in the non-DELC group (log-rank test, <i>p</i> = 0.02). Compared with patients without DELC, patients with DELC had a high risk of AF development (adjusted hazard ratio = 1.88, 95% confidence interval = 1.01-3.53). <b>Conclusions</b>: DELC is associated with an increased risk of AF in patients with CAD. These findings may aid in the detection of AF in patients with CAD.