Background竊�There are very limited data regarding the influences of previous myocardial infarction (MI) on the outcomes of recurrent acute ST-segment elevation MI (re-STEMI) patients (pts), especially after primary percutaneous coronary intervention (PCI) in DES era. Method: The current data came from the Korea Acute Myocardial Infarction Registry (KAMIR), which consisted of 4,726 consecutive acute MI pts underwent primary PCI from November 2005 to April 2008. Among 4,726 pts survived after primary PCI, 313 (6.62%) pts had previous MI history. We compared the clinical outcomes of re-STEMI with those of first-onset STEMI (first-STEMI group, n=4413) at 12-month.Results: The baseline characteristics are largely unfavorable in re-MI group over first-AMI group. Pts in re-AMI group were older (64.95짹12.3 vs 63.3짹12.7, p=0.001), more male (74.1% vs 70.0%, p=0.003), NSTEMI (50.9% VS 37.9%, P<0.001), worse cardiac function (Killip III/IV, 21.1% vs 13.0%, p<0.001), and more prior revascularization history (p<0.001) than those of first-AMI group. Angiographic findings also demonstrated unfavorable characteristics in re-AMI group including more multi-vessel disease (p<0.001), smaller culprit vessel diameter (3.08짹0.43 vs 3.16짹0.43, p<0.001), less procedural success rate (p<0.001) and more CABG (p<0.001). Despite these different baseline characteristics, once pts with previous MI presented with re-STEMI, they showed similar clinical outcomes including cardiac death, TLR, TVR, and recurrent AMI except higher CABG rate(1.6% vs 0.2%, p<0.001 ) following primary PCI with those of first-AMI group at 12-month.Conclusion: Depite the pts with recurrent STEMI presented with worse baseline clinical and procedural characteristics, but demonstrated similar clinical outcomes except for the higher CABG rate with those of the pts with first-AMI up to 12-month following primary PCI, emphazising the benefit of early revascularization regardless of pt���s baseline characteristics.