<h4>Background</h4>The neutrophil-to-lymphocyte ratio (NLR) may be a useful marker of inflammation, but its associations with clinical characteristics, signs of congestion and outcome in patients with chronic heart failure (HF) are unknown.<h4>Methods and results</h4>We enrolled 4702 ambulatory patients with HF and either left ventricular systolic dysfunction or high N-terminal pro-B-type natriuretic peptide (NTproBNP) (≥125 ng/L). This evidence concerns the gene NPPB and congestive heart failure.