Department of Cardiology, The Second Hospital of Jilin University, Changchun, Jilin, China.
Department of Cardiology and Cardiovascular Research Institute, Chinese People's Liberation Army, General Hospital of Northern Theater Command, Shenyang, Liaoning, China.
Front Endocrinol (Lausanne). 2023 Feb 28;14:1108234. doi: 10.3389/fendo.2023.1108234. eCollection 2023.
The role of fibroblast growth factor 21 (FGF21) in predicting the long-term prognosis of patients with cardiovascular disease (CVD) remains unknown.
A comprehensive search in PubMed, Embase, and the Cochrane Library was performed to identify studies reporting the association between FGF21 and prognosis among patients with CVD. A meta-analysis was performed, with patients stratified by coronary artery disease (CAD) or heart failure (HF). The endpoint of CAD or HF was major adverse cardiovascular events defined by each study and a composite of death or HF readmission, respectively. The I method and linear regression test of funnel plot asymmetry were used to test heterogeneity (I > 50% indicates substantial heterogeneity) and publication bias (asymmetry P < 0.05, indicating publication bias).
A total of 807 records were retrieved, and nine studies were finally included. Higher FGF21 levels were significantly associated with the risk of major adverse cardiovascular events in patients with CAD (multivariate hazard ratio [HR]: 1.77, 95% confidence interval [CI]: 1.40-2.23, P < 0.05, I = 0%, fixed-effect model). Increased FGF21 levels were also associated with the risk of all-cause death among patients with CAD (multivariate HR: 2.67, 95% CI: 1.25-5.72, P < 0.05, I = 64%, random-effect model). No association was found between FGF21 and the endpoint among patients with HF (HR: 1.57, 95% CI: 0.99-2.48, P > 0.05, random-effect model), but a large heterogeneity (I = 95%) and potential publication bias (Asymmetry P < 0.05) existed in the analysis.
Increased FGF21 levels were independently associated with poor prognosis of CAD, whereas the role of FGF21 in predicting clinical outcomes of HF requires further investigation.
成纤维细胞生长因子 21（FGF21）在预测心血管疾病（CVD）患者的长期预后中的作用尚不清楚。
在 PubMed、Embase 和 Cochrane 图书馆中进行了全面检索，以确定报告 FGF21 与 CVD 患者预后之间关联的研究。对患者进行了分层分析，分为冠状动脉疾病（CAD）或心力衰竭（HF）。CAD 或 HF 的终点由每个研究定义的主要不良心血管事件和死亡或 HF 再入院的复合终点来表示。采用 I 方法和漏斗图不对称线性回归检验来检测异质性（I > 50%表示存在显著异质性）和发表偏倚（不对称 P < 0.05，表示存在发表偏倚）。
共检索到 807 条记录，最终纳入 9 项研究。较高的 FGF21 水平与 CAD 患者发生主要不良心血管事件的风险显著相关（多变量风险比[HR]：1.77，95%置信区间[CI]：1.40-2.23，P < 0.05，I = 0%，固定效应模型）。较高的 FGF21 水平也与 CAD 患者全因死亡风险相关（多变量 HR：2.67，95% CI：1.25-5.72，P < 0.05，I = 64%，随机效应模型）。FGF21 与 HF 患者的终点之间无相关性（HR：1.57，95% CI：0.99-2.48，P > 0.05，随机效应模型），但分析中存在较大的异质性（I = 95%）和潜在的发表偏倚（不对称 P < 0.05）。
较高的 FGF21 水平与 CAD 的不良预后独立相关，而 FGF21 在预测 HF 临床结局中的作用需要进一步研究。
