Data regarding the safety of using drug-eluting stents(DES) in ST-elevation acute myocardial infarction(STEMI) are limited with small,randomized clinical trials. Further, there were no published data regarding the head to head comparison of the efficacy and safety of different DES for primary percutaneous coronary intervention (PCI) in STEMI. This study was aimed to establish the efficacy and safety of coronary stenting with Zotarolimus-eluting stents(ZES) compared to Sirolimus-eluting stents(SES) and Paclitaxel-eluting stents(PES) for primary PCI in STEMI. Since October 2006, a prospective,randomized multi-center trial of total 600 patients has been performing at 11 centers in Korea. After random assignment to SES, ZES or PES, the index PCI procedure must be carried out immediately. All patients will be clinically followed-up for two years. Angiographic follow-up is routinely recommended for angiographic sub-studies. The primary endpoint was the composite of cardiac death, recurrent MI and ischemia-clinically driven target lesion revascularization (TLR) at 12 months. Acute, subacute and late stent thrombosis (ST) by ARC definition will be analyzed. Total 227 patients who were completed follow-up more than one month were analyzed. Baseline clinical, angiographic and time variables were well matched without statistical differences among three groups. Used stent size and length were 3.18 짹 0.33 mm and 25.5 짹 6.1 mm, 3.18 짹 0.40 mm and 24.5 짹 4.9 mm, 3.35 짹0.41 mm and 24.9짹5.2 mm in SES-(n=76), ZES-(n=72) and PES-group(n=79), respectively. Acute gain was 2.84 짹 0.06 mm, 2.82 짹 0.07 mm and 2.81 짹 0.09 mm in SES-, ZES- and PES- group, respectively. Three months cumulative major adverse cardiac events were 3.9%(one recurrent MI, two TLR), 2.7%(one cardiac death, one TLR) and 1.2%(one TLR) in SES-,ZES- and PES- group, respectively. One acute ST in ZES-group and two subacute ST in SES-group were noted. Conclusions: DES in STEMI was safe. Campared to Sirolimus- and Paclitaxel-eluting stents, Zotarolimus-eluting stents were not different in terms of clinical MACE and ST at midterm follow-up. Long-term data will be warranted to document the efficacy and safety of the different DES in patients with STEMI.