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[Frank's sign and coronary disease].

The authors study the sensitivity, the specificity and the predicting value of Frank's sign (presence of a groove at the level of the earlobe) on a group of 172 patients undergoing a clinical examination, an EKG at rest and effort, and a selective coronary arteriogram for suspicion of coronary disease. The criteria retained for the diagnosis of coronary disease is the presence of stenosis superior or equal to 75 p. cent in one of the three main coronary vascular trunks. Statistical studies using the CHI 2 test reveal a highly significant association between Frank's sign and coronary disease (p less than 0.001). The sensitivity of Frank's sign reaches 75 p. cent, its specificity 57.5 p. cent and its positive predicting value 80.3 p. cent. The predicting value is a function of the sex: it is a great deal lower in women (50 p. cent) than in men (84.7 p. cent). The prevalence of Frank's sign increases progressively with age: 42 p. cent in the 30-39 age group and 75.8 p. cent in the 60-69 age group. The predicting value remains high however beyond 60 years: predicting value of 77 p. cent. Frank's sign is correlated neither with the gravity of the coronary disease, nor the duration of the angina, nor with any of the risk factors studied here: tobacco, hypercholesterolemia, arterial hypertension, diabetes, obesity. Frank's sign is therefore considered as a marker of the coronary disease, independent of risk factors but frequently associated with them. If its absence does not permit in any way to exclude the diagnosis of coronary disease, its presence corresponds in three quarters of the cases to an established coronary disease within a symptomatic population.(ABSTRACT TRUNCATED AT 250 WORDS)

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