Backgrounds: Patients with chronic renal insufficiency (CRI) have been reported having high incidence of mortality, stent thrombosis and restenosis after percutaneous coronary intervention (PCI). There are a few studies that drug eluting stent is superior to bare metal stent in patients with CRI in terms of 1-year major adverse cardiovascular event (MACE) rate. So, this study is aimed to find out better coronary stents for patients with CRI. Methods: Among consecutive 6749 patients performed percutaneous coronary intervention (PCI) in COACT (CathOlic medical center percutAneous Coronary inTervention) registry from January 2004 to December 2009, we analyzed 741 patients with CRI. CRI was defined as estimated Glomerular filtration rate (GFR) below 60ml/min by Modification of Diet in Renal Disease (MDRD) methods. We analyzed a composite of MACE including death, myocardial infarction (MI), and target vessel revasculariztion (TVR). Results: Among all of patients with CRI, patients received PCI with sirolimus-eluting stent (SES) is 451 (60.9%), paclitaxel-eluting stent (PES) is 290 (39.1%). There were no differences in baseline characteristics except previous MI, previous PCI, acute coronary syndrome (ACS), which factors were more in PES group. SES group had higher low density lipoprotein (LDL) cholesterol and lower left ventricular ejection fraction. The low efficacy of PES was pronounced in terms of MACE (adjusted hazard ratio 1.965, 95% confidence interval 1.367-2.824, p<0.001) by cox hazard regression analysis. Conclusion: SES is superior to PES with respect to MACE in patients with CRI.