Background: It is unclear whether the routine follow up (FU) coronary angiography (CAG) regardless of patient���s symptoms after successful primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) in acute ST elevation myocardial infarction (STEMI) patients (pts) is beneficial or not. Methods: The study population consisted of 218 consecutive STEMI pts underwent primary PCI from November 2005 to June 2008. Routine FU CAG was performed between 6 to 9 months following index PCI and was decided by individual physician���s discretion. Pts died before 6 months were excluded in both groups. Cumulative clinical outcomes up to 2 years were compared between Routine CAG group (n=150 pts, 75.7%) and Clinical FU group (n= 68 pts, 34.3%). Results: A total 198 pts (90.8%) were followed up to 2 years. Both groups had similar Baseline clinical and procedural characteristics were similar between the two groups except chronic renal insufficiency was higher in the Clinical FU group (7.4 vs. 1.3, p=0.020). Routine CAG group had lower incidence of cumulative cardiac death and recurrent Q-wave MI up to 2 years, however, there were no difference in the incidence of repeat revascularization and major adverse cardiac events (Table). Conclusions: In our study, routine CAG FU after successful primary PCI with DESs in pts with STEMI was associated with lower incidence of cardiac death and recurrent Q-wave MI up to 2 years, suggesting better durable long-term clinical outcomes of routine CAG FU strategy compared to clinical FU only strategy.