The study investigated the relationship between the CRP-TyG index (CTI), which combines systemic inflammation and insulin resistance, and synthetic liver function in intensive care unit (ICU) patients within 24 hours after myocardial infarction. She retrospectively analyzed 286 laboratory samples, evaluating serum albumin (ALB), prealbumin (PA), and the ratio of total bilirubin to albumin (TBIL/ALB). Higher CTI values were independently associated with lower levels of albumin (β = -1.23 g/L, p < 0.001) and prealbumin (p < 0.001), but not TBIL/ALB ratio (p = 0.135). Patients in the highest CTI quartile had significantly lower ALB (-2.19 g/L, p = 0.002) and PA (-56.05 mg/L, p < 0.001) compared to the lowest quartile, the relationship being linear. Addition of CTI improved the predictive power of ALB and PA levels, but not TBIL/ALB. The effects were more pronounced in men than in women. Sensitivity analyzes confirmed the stability of the results even after excluding patients with death, pressure treatment or continuous renal replacement therapy. An increased CTI is thus correlated with a reduced synthetic function of the liver in the first 24 hours after a myocardial infarction.