Introduction : Drug eluting stent (DES) have proven efficacy in reducing angiographic restenosis and improves cardiac event compared with bare metal stents (BMS). And this benefit had also proven in acute myocardial infarction. The aim of this study was to compare DES and BMS outcomes in acute myocardial infarction with moderate to severe LV dysfunction. Methods : We included 736 patients (Male 71.9%, Age 63.1짹12.6 yr) with acute myocardial infarction who had moderate to severe LV dysfunction(LV ejection fraction ��� 40%) and underwent percutaneous coronary intervention in Korea Acute Myocardial Infarction Registry (KAMIR). Baseline clinical characteristics, laboratory result and angiographic findings were checked. Patients were retrospectively followed for the occurrence of major adverse cardiac events (MACE). Results : There was no significant difference in clinical characteristics and laboratory, angiographic findings between DES group (680 patients, 92.4%) and BMS group (56 patients, 7.6%) except for peak troponin I level (60.4짹117.3 in DES group, 129짹181.1 in BMS group, p=0.011). Baseline LV ejection fraction was 33.6짹5.9% in DES group and 32.7짹6.1% in BMS group (p>0.05). Major adverse cardiac event events occurred in 163 patients (22.2%) at 6 month follow-up. Use of DES was independent predictor of lower MACE in multivariate survival analysis [HR=2.094, p=0.04, CI : 1.019-4.303]. Incidence of MI/death was also significantly lower in DES group [HR=2.493, p=0.028, CI : 1.013-5.639]. Conclusion : Utilization of DES in the setting of acute myocardial infarction with moderate to severe LV dysfunction improved clinical outcomes compared with BMS.