Background: Patients with acute decompensated heart failure (ADHF) may experience major consequences from type 1 cardio renal syndrome (CRS), which can have a major impact on HF patients. Urine Cofilin-1 measured by the gold nanoparticle-based immunoassay LSPCFB could be used as a single biomarker for CRS prediction in patients in critical care units. So we aimed to evaluate performance of urine cofilin-1 as a predictor for type 1 Cardio renal Syndrome patients using Gold Nanoparticle- and Laser-Based Approach in coronary care unit. Methods: A case-control study was conducted on 60 subjects admitted to the Coronary Care Unit (CCU). Participants were divided into four groups based on heart and renal function status. Urine Cofilin-1 levels were measured using ELISA and LSPCFB. Patients were monitored for 7 days to confirm CRS development based on KDIGO criteria. Results: Urine Cofilin-1 levels were significantly elevated in CRS patients compared to other groups. The LSPCFB method showed superior specificity and overall diagnostic accuracy (AUC = 0.678) compared to ELISA. Correlations were observed between Cofilin-1 levels and several renal and cardiac function parameters. LSPCFB showed higher diagnostic performance, with an optimal cutoff of ≥0.3 and acceptable sensitivity (73.3%) and specificity (70%). Conclusion: Urine Cofilin-1 is a promising early biomarker for detecting Type 1 CRS, especially when measured using the LSPCFB technique.