Abstract

Abstract Background and Aims Hemodialysis (HD) patients had higher cardiovascular mortality due to accelerated atherosclerosis in such patients. Epicardial adipose tissue (EAT) thickness is a marker of atherosclerosis and independent predictor of coronary artery disease. The potential use of EAT as an imaging biomarker for cardiovascular disease risk stratification has attracted attention in the recent times. EAT's value in cases of HD hasn't been thoroughly analyzed, though. A meta-analysis of the literature assessing the mean differences in EAT value between HD patients and healthy controls was conducted. Method Pubmed, Google Scholar and Embase databases were searched from inception till 15 January 2024 for studies that measured EAT thickness of adult patients with HD and matched healthy controls. Outcomes included mean difference (MD) and 95% confidence interval (CI) of EAT thickness between the HD patients and the healthy controls. The results were combined using a fixed or random effect model as per heterogeneity among the included studies in Revman 5.4 software. The between-study heterogeneity of effect size was quantified using the Q statistic and I2. The results were represented in forest plots. Statistical significance was determined as P value of less than 0.05. Results Eight studies comprising 757 patients were included in this analysis. EAT thickness were significantly higher in HD patients as compared to healthy controls [MD: 1.88, Confidence Interval (CI): 0.74-3.02, I2 = 98%, P value = 0.001] (Fig. 1). Conclusion This meta-analysis concluded that HD patients are independently associated with higher EAT as compared to healthy controls. The utility of EAT as an imaging biomarker for predicting atherosclerosis in HD patients is promising. EAT represent readily available clinical markers useful in estimating risk of cardiovascular mortality in HD patients.

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