Aim: This study aims to compare the extended biochemical profile of unselected and consecutive systolic heart failure (SHF) patients admitted electively and urgently to the tertiary cardiology center. Methods: This study is a retrospective analysis of the 310 consecutive SHF patients who were hospitalized between January 2011 till December 2013. Data about health status of the patients, medications, as well as laboratory data, including indicators of myocardial damage, such as high–sensitivity troponins (hs-Tn), MB isoform of creatin kinase (CK-MB), marker of myocardial strain (NT-proBNP) and inflammatory parameters [high-sensitivity C-reactive protein (hs-CRP) and white blood cell count (WBC)] were gathered from medical histories and documentations. Results: Out of 310 patients more than a half (n=172, 55%) were admitted electively. Urgent patients had higher heart rate, NYHA class, and lower left ventricular ejection fraction (EF). Elective ischemic cardiomyopathy (ICM) patients were more likely to be older male with higher EF, and increased level of hs-TnT and CK-MB. As for urgent admissions, the frequency of male sex was similar in both groups but ICM patients were significantly older, had worse kidney function, and increased level of hs-TnT and NT-proBNP than patients with dilated cardiomyopathy (DCM). Conclusions: Systolic HF patients admitted electively and urgently differ significantly. Moreover, patients with different HF etiologies, such as ischemic and dilated cardiomyopathy, admitted either electively or urgently have different profiles. The observed elevation of ischemic and inflammatory parameters in decompensated HF may indicate possible mechanisms of HF worsening, leading to the acute admissions. The true meaning of the observations as well as potential additional anti-inflammatory and/or anti-ischemic treatment in stable HF to prevent acute episodes could a subject for further studies. JRCD 2014; 1 (7): 7–12