Kwok CS, et al. - In this cohort study, researchers assessed discharge against medical advice (AMA) in acute myocardial infarction (AMI) patients and its impact on readmissions. Participants were AMI patients in the US in the Nationwide Readmission Database who were admitted between 2010 and 2014. Descriptive statistics were given for variables according to discharge home or AMA. All-cause 30-day unplanned readmissions and their causes was the primary end point. According to findings, 1.5% of the population with AMI had a discharge AMA. These subjects had a higher risk of early readmissions for re-infarction. Discharge AMA was independently predicted unplanned all-cause readmissions, and patients who discharged AMA had a greater than twofold increased crude rate of readmission for AMI and higher crude rate of admissions for neuropsychiatric reasons. Findings called for the development of interventions to reduce discharge AMA in high-risk groups and for initiating interventions to avoid adverse outcomes and readmission.