Background: There is little information on cardiac outcomes in the Zotarolimus Eluting Stent (ZES), compared with the Sirolimus Eluting Stent (SES) and the Paclitaxel Eluting Stent (PES) in acute myocardial infarction. The study was designed to investigate the effectiveness and safety of ZES implantation in acute myocardial infarction Method: Four hundred five consecutive patients with acute myocardial infarction in IPS(Infarct Prognosis Study) Registry [ST elevation myocardial infarction; n=225(55.6%), Non-ST elevation myocardial infarction; n=180(44.4%)], underwent percutaneous coronary intervention at Severance Hospital, were randomly assigned to be implanted SES, PES, or ZES. We assessed the adverse cardiac events [Cardiovascular death, Non-fatal myocardial infarction, and Target vessel revascularization (TVR)] among three group (SES, n=197, PES, n=114, ZES, n=94). The mean follow-up duration was 20.1 짹 10.2 months (up to 38 months). Results: The baseline characteristics were comparable among the three groups. The cumulative mortality rate was comparable in the three groups: 6.6% in the SES group, 4.4% in the PES group, and 4.3% in the ZES group (non-significant for all). The rate of TVR was 8.5% in the ZES group compared with 2.0% and 4.4% in the SES and PES group, respectively (p=0.008 for ZES vs. SES, 0.133 for ZES vs. PES, 0.252 for SES vs. PES). The cumulative incidence of cardiovascular death, non-fatal MI, or TVR was 12.8% in the ZES group compared with 10.7% in the SES group, 12.3% in the PES group (p=0.220 for ZES vs. SES, 0.456 for ZES vs. PES, 0.655 for SES vs. PES). Stent thrombosis(ST), which was defined as definitions of the Academic Research Consortium(ARC), was investigated during the study period. The rate of ST was 1.1% in the ZES group, 2.5% in the SES group and 0.9% in the PES group (p=0.474). Conclusion: Our data demonstrated that the cumulative of adverse cardiac event and non-fatal MI were not significantly different among the three groups. But, ZES had a higher rate of TVR than SES or PES.