Backgrounds : There are limited data regarding the clinical outcomes of first generation drug eluting stents (DES) over 2 years after percutaneous coronary intervention (PCI). The aim of present study is to demonstrate the long term clinical outcomes of Sirolimus eluting stents (SES) and paclitaxel eluting stents (PES). Methods : We analyzed consecutive 6749 patients in the COACT (CathOlic medical center percutAneous Coronary inTervention) registry from Jan 2004 to Dec 2009. Among these patients, 3227 patients who underwent PCI with single type of DES (PES=1,031; SES=2,187) were selected from Jan 2004 to Dec 2008. We analyzed stent thrombosis and major adverse cardiac events (MACE) including death, myocardial infarction, and target vessel revacularization after procedure. Results : Over a median follow up of 36.3 months (interquatile range: 22.1-48.5), 369 SES (16.9%) patients had a MACE, compared to 213 PES (20.7%) patients (p=0.011). PES implantation was an independent risk factor of MACE in multivariate Cox regression (adjusted hazard ratio [HR] 1.271, 95% confidence interval [CI] 1.065 to 1.518, p=0.008). However, MACE rate of SES patients caught up that of PES patients at 5 year after procedure in Kaplan-Meier curve (figure). After 2 year of stent implantation, MACE rate of PES patients was similar to that of SES patients (5.9% v.s 8.2%, p=0.079). In multivariate analysis, PES was not an independent risk factor (95% CI 0.486 to 1.061). Conclusions : In this real world registry, cumulative adverse clinical events of SES may be similar to those of PES in process of time. We are planning to announce further data with complete registry including over ten thousand patients.