AbstractBackground: Heart failure (HF) is an important and common cardiovascular health problem seen in day today practice with significant mortality and morbidity. HF patients require timely evaluation, emergent and appropriate therapyas they usually present with acute onset of dyspnea to emergency department. Proper risk-stratification is a prerequisite to identify high risk group for adverse outcomes which directs us in proper management and plan timely follow up of the patients. Methods: This was a prospective,single centre study involving 102 consecutive AHF patients in NYHA class III/ IV who were enrolled over a period of 6 months from October 2013 to march 2014. Patients with acute coronary syndrome, significant renal, hepatic or valvular heart disease, sepsis and pulmonary embolism were excluded. ST-2, hs-TropT, hs-CRP and Uric acid were evaluated at admission. Results: The mean admission values of ST-2 were 100.2±66.6ng/ml. ST-2 values found significantly raised in Group 1 (HFrREF) compared to Group 2 (HFpEF) (108.7±66.6 Vs 63.9±39.7) which is statistically significant (p=0.001). ST-2 is raised in group with events compared to non-event group but statistically insignificant (p=0.078). Conclusions: Although ST-2, hsTropT, hsCRP and UA were all elevated in the vast majority of patients, None of them were independent predictor of adverse outcomes on follow-up. But Several important relations of biomarkers with various outcomes were derived in this study.