Objectives: Aim of this study was to examine the association of the ratio of C-reactive protein (CRP) to albumin with the marker of heart failure, renal function, electrolyte status, therapy in the treatment of heart failure, echocardiographic measurments and outcome three months after hospitalization. Study design: Cohort study from historical data Participants and methods: The study included patients treated for heart failure at the Department of Cardiovascular Diseases, University Hospital Center Osijek, in the period from January 1. 2020 to October 1. 2020. Patients with acute myocardial infarction and active malignancy were excluded. Results: The study included 145 patients. The median ratio of CRP to albumin was 3.32 (interquartile range 1.39 to 6.84). Patients treated with mineralocorticoid receptor antagonist (P = 0.02) and / or loop diuretic (furosemide) (P = 0.04) had a significantly higher ratio of CRP to albumin. A significant positive correlation was observed between CRP and albumin ratio with neutrophil percentage, RDW, NT-proBNP and urate concentration, while a significant negative correlation was observed with diastolic pressure, lymphocyte percentage, hemoglobin, prothrombin time and sodium concentration. No association was found between the ratio of CRP to albumin and urea, creatinine, potassium concentration and echocardiographic measurments. Patients with fatal outcome had a higher ratio of CRP to albumin during the three-month follow-up (P = 0.04). Fatal outcome was more common in patients with chronic obstructive pulmonary disease, mineralocorticoid receptor antagonist and / or loop diuretic (furosemide) in therapy, lower systolic and / or diastolic blood pressure and higher urea, creatinine, and urate concentration. Conclusion: The ratio of CRP to albumin shows a greater association with the three-month survival of patients hospitalized for heart failure than CRP and albumin alone.