Objective: Hypoalbuminemia is common in heart failure (HF), especially in elderly patients. It is associated with an increased risk of death. The present study sought to examine the prognostic significance of serum albumin level in the prediction of long-term mortality in patients admitted for acute HF.Methods and results: We examined the association between albumin and hospital mortality in a cohort of 509 patients admitted for acute HF. None of the patients had infectious disease, severe arrhythmias (atrial fibrillation, ventricular tachycardia, ventricular fibrillation), required invasive ventilation or presented with acute coronary syndrome or primary valvular disease. Sixty-nine patients (14%) died during the 1-year follow-up. With multivariable analysis, haemoglobin level (p = .003), systolic blood pressure (p = .004) and serum albumin level (p = .003) emerged as independent predictors of long-term mortality. Hypoalbuminemia (<35.7 g/L) had a hazard ratio of 2.01 (95% CI 1.24-3.25) and haemoglobin of 2.6 (95% CI 1.29-5.22) for predicting long-term mortality.Conclusions: Serum albumin level measured at admission, especially if combined with anaemia, can serve as a simple prognostic factor in acute HF for predicting long-term outcome.