Fibroblast growth factor-23 (FGF-23) level has been linked the adverse outcomes in patients with coronary artery disease (CAD). The purpose of this meta-analysis was to assess the predictive value of blood FGF-23 levels in CAD patients.

Two authors comprehensively searched PubMed and Embase until 20 August 2021 to identify studies investigating the association of FGF-23 level with adverse outcomes in CAD patients. Outcomes of interest were major adverse cardiovascular events (MACEs), cardiovascular or all-cause mortality.

Eight studies with 16,702 patients with CAD were identified. Pooled results showed that elevated FGF-23 level was associated with a higher risk of MACEs (risk ratio [RR] 1.56; 95% confidence intervals [CI] 1.32–1.84), cardiovascular mortality (RR 1.99; 95% CI 1.38–2.86), and all-cause mortality (RR 1.95; 95% CI 1.67–2.27) after adjusted confounding factors. In addition, per doubling increase in the FGD-23 level was associated with a 24% higher risk of MACEs. Each standard deviation increase in the FGD-23 level conferred a 36% higher risk of cardiovascular mortality.

Elevated blood FGF-23 level is associated with a higher risk of MACEs, cardiovascular or all-cause mortality in patients with CAD, even after adjustment for renal function. Blood FGF-23 level may provide important predictive information in CAD patients.