Backgrounds: There has been studies comparing bare-metal stents with drug-eluting stents, and paclitaxel-eluting stents (PES) with everolimus-eluting stens (EES). However, no study has been reported comparing everolimus-eluting versus sirolimus-eluting stents (SES). Methods: We analyzed consecutive 6749 patients performed percutaneous coronary intervention (PCI) with drug eluting stents (DESs) in COACT (CathOlic medical center percutAneous Coronary inTervention) registry from January 2004 to December 2009. Primary endpoint was a composite of major adverse cardiac events (MACE) including all-cause death, non-fatal myocardial infarction, and target vessel revascularization. Results: Of these, 3420 subjects (SES=2463, EES=957) have received PCI. During median follow up of 18 months, 242 SES patients (9.8%) and 98 EES patients (9.2%) had a MACE (p=0.703). Despite adjusting multiple covariates including age, sex, diabetes mellitus, hypertension, smoking, family history of coronary artery disease, history of ischemic heart disease, chronic kidney disease (>2.0 mg/dL), initial ejection fraction by echocardiography, disease subset(stable angina, acute coronary syndrome, silent ischemia), angiographic parameter(target vessel number, lesion site, stent diameter, stent length, stent number to patient), EES was non-inferior to SES with respect to the primary end point at 18 months after stent implantation (adjusted odds ratio 1.105, 95% confidence interval 0.849 to 1.439, p=0.4598) Conclusion: During 18 month follow up, everolimus-eluting stents is not inferior to sirolimus-eluting stens in rates of composite of all cause death, non-fatal myocardial infarction, and target vessel revascularization.