BACKGROUND: Drug-eluting stent (DES) has been proven its efficacy in randomized trial. But the difference of efficacy between sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) in unselected patients is in controversy. Therefore, we investigated the clinical and angiographic outcomes of two type of DES. METHODS: In daily practice of coronary intervention,SES and PES implantation have been used as the default strategy as part of the SNUH-Cohort since March, 2003. RESULTS : Our consecutive 440 patients with 519 lesions who were treated with DES were analyzed(SES 353 lesions/ 296 pts, PES 166 lesions/144 pts). PES had more AMI patients (PES 22.2% vs. SES 14.2%, p=0.035) in the baseline clinical characteristics. Angiographically, number of stents per lesion (PES 1.38 짹0.66 vs. SES 1.27 짹0.53, p=0.032), maximal pressure deployment (PES 11.5 짹3.5atm vs. SES12.4 짹 2.6atm, p=0.002) and percentage of disease segment after procedure (PES 3.42 짹14.5% vs. SES 0.74 짹12.3%, p=0.038) were different between two groups. At sixmonth clinical follow up, PES had more major adverse cardiac events (MACE, any cause of death, myocardial infarction, target lesion revascularization and target vessel revascularization) than SES (PES 15.1% vs. SES 5.1%, p<0.0001). In the angiographic follow up at six months, we studied 321 lesions (PES 102 lesions, SES 219 lesions). PES had more binary restenosis rate (PES 12.7% vs.SES 3.1%, p<0.0001) and late loss (PES 0.60 짹 0.83mm vs. SES 0.16 짹 0.40mm, p<0.001) than SES. At 1 year clinical follow up, PES also had more MACE than SES (PES 20.1% vs. SES 6.08%, p<0.0001). In the multivariate analysis, PES were significant predictor of MACE at 1 year (odds ratio 3.89, 95% confidence interval 2.08-7.29). CONCLUSION: Unselected utilization of 2 type drug-eluting stents is safe and effective in reducing repeated revascularization. SES showed significantly better clinical and angiographic outcomes within 1 year compared with PES. We cannot rule out that unfavorable baseline clinical and angiographic characteristics of PES group exaggerated the difference between two type of stents.