Background: This study examined the effect of oral nicorandil on long-term clinical outcomes after percutaneous coronary intervention in patients with acute myocardial infarction (AMI). Methods: As part of the Korean Acute Myocardial Infarction Registry (KAMIR), we enrolled 5,864 eligible patients with discharge medication undergoing a 1-year follow-up after percutaenous coronary intervention for acute myocardial infarction from October 2005 and January 2008. The patients were divided on the basis of prescription for oral nicorandil on discharge. The occurrences of death, myocardial infarction, repeat pecutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABG) were collected over 1-year follow-up. Results: Of the 5,864 patients, 1,187(20%) were prescribed an oral nicorandil at discharge. By 1-year follow-up, incident events were 195 deaths, 46 MI, 440 repeat PCI and 18 CABG. There were no significant differences in age, sex, comorbidities, blood pressure, Killip class, creatinine clearance, left ventricular ejection fraction, N-terminal pro-B-type natriuretic peptide and angiographic findings between two groups. High-sensitivity C-reactive protein level was lower in nicorandil group. Postdischarge oral nicorandil therapy was not associated with lower risks of death, MI, repeat PCI and CABG. Conclusion: Postdischarge oral nocorandil therapy has no beneficial effect on long-term clinical outcomes after percutaneous coronary intervention in AMI patients.