Objective: To determine the link between heart rate variability (HRV) and short-term adverse outcomes (re-hospitalisation or death due to cardiac arrhythmia, recurrent myocardial infarction, heart failure, all-cause death) in acute myocardial infarction (AMI). Study Design: A descriptive study. Place and Duration of the Study: Department of Cardiovascular Medicine, The First A liated Hospital of Anhui Medical University, China, from January 2018 to December 2021. Methodology: Clinical data of 245 patients diagnosed with AMI were retrospectively analysed. After discharge from the hospital, patients were followed for a year and categorised into two groups based on the occurrence of adverse events: the adverse event group (n=82) and the no adverse event group (n=163). Di erences in clinical characteristics were compared, independent factors in uencing adverse events were analysed, and diagnostic e cacy was assessed. Results: Univariate analysis showed age, hyperlipidaemia, speci c HRV parameters (SDNN, SDANN, RMSSD, PNN50, LF/HF), and myocardial injury markers (CK-MB, cTnI, NT-proBNP) as associated with these events (all p < 0.05). Multivariable analysis revealed decreased SDNN, decreased SDANN, increased LF/HF, and elevated levels of CK-MB, cTnI, and NT-proBNP as independent in uences. Both HRV parameters and myocardial injury markers were reliable predictors on ROC curve analysis. The highest diagnostic e cacy was achieved by combining these predictors. Conclusion: AMI patients frequently experience short-term adverse events. Both HRV parameters and myocardial injury markers, which demonstrate signi cant predictive e cacy, independently in uence these outcomes.