Anti-inflammatory molecules have been explored as possible options in heart failure therapies, and identifying patients with elevated NLR could facilitate the more effective tailoring of the modern five pillars used as fundamental HF therapy: (i) diuretics, (ii) sodium-glucose cotransporter-2 inhibitor, (iii) angiotensin-convertin enzyme inhibitors/angiotensin receptor-neprilysin inhibitor/angiotensin, (iv) receptor blockers/mineralocorticoid receptor antagonist, and (v) beta-blockers. This evidence concerns the gene NR3C2 and heart failure.