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 (I2 = 95%) and potential publication bias (Asymmetry P < 0.05) existed in the analysis. This evidence concerns the gene FGF21 and hydrops fetalis.