Abstract: Objective： To explore the predictive value of serum hypersensitive C-reactive protein(hs CRP) to prealbumin(PAB) ratio，NT-pro BNP，LVEF levels in patients with acute myocardial infarction(AMI) complicated with heart failure (HF). Methods： Sixty-four patients with AMI admitted from January 2017 to June 2018 in our hospital were selected as the study subjects， and blood glucose， blood pressure， blood lipids， myocardial infarction and other relevant indicators were measured. According to Killip cardiac function grading， AMI patients were divided into HF group (n=31) and non-HF group (n=33). Clinical indicators of the two groups were compared， the predictive value and diagnostic efficacy of hs CRP/PAB for HF in patients with AMI were analyzed. Results： Compared with non-HF group， the age， CKMB， NT-pro BNP， and hs CRP and ln(hs CRP/PAB) were significantly increased in HF group， while LVEF， PAB were significantly decreased (P<0.05). With the increase of Killip cardiac function grading， serum hs CRP and ln(hs CRP/PAB) of AMI patients combined with HF were significantly increased， and PAB was significantly decreased (P<0.05). Multivariate logistic regression showed that NT-pro BNP and ln(hs CRP/PAB) were independent risk factors for HF in AMI patients， while LEVF was a protective factor (P<0.05). Conclusion： Hs CRP/PAB is an independent risk factor for HF in AMI patients. The combination of serum hs CRP/PAB， NT-pro BNP and LVEF can help predict and evaluate HF in AMI patients， and guide the clinical decisions.