BACKGROUND: Many Korean veterans participated in Vietnam War resulting in exposure to Agent Orange (AO) and its containments dioxin. AO exposure is said to boost hypertension and heart disease but clinical data on links between AO and ischemic heart disease are limited. This study was conducted to determine whether AO exposure was associated with coronary artery disease and evaluate the clinical outcome of theses patients after coronary intervention in a single-center retrospective cohort study. METHODS: From August 2003 to July 2007, 1500 consecutive patients were registered in our database of coronary intervention. Ninety one Vietnam veterans were included in this study. Among the patients who underwent elective coronary intervention during the same period, 74 non-Vietnam veterans were selected by matching the age. We reviewed and analyzed the medical records and coronary angiograms. Nine-month angiographic and clinical follow-up was completed in all patients and survival analysis was performed for this population. Cardiogenic shock and ST-elevation myocardial infarction were excluded. RESULTS: There were no significant differences in the baseline characteristics including baseline left ventricular ejection fraction except higher frequency of hypertension (71%) in AO than control (32%) group. Multiple logistic regression was performed to estimate the effect of ���service in Vietnam��� adjusting for age, smoking, and mass index. Vietnam veterans had an increased frequency of hypertension (OR=2.29), compared to non-Vietnam veterans, adjusting for potential confounders. There was no significant difference in the major adverse events free survival rate including cardiac death, myocardial infarction, and cerebrovascular events at 12 month (96.6%, 96.0%) between two groups. There was no difference in revascularization-free survival rate at 9 month (9.6%) and subacute thrombosis between two groups (0.87%). CONCLUSIONS: Although this is non-randomized retrospective study, our data shows that exposure to AO may be associated with heart disease or heart disease risk factors in Korean Vietnam veterans and clinical outcomes of two groups are comparable each other.