Background: There are few studies comparing the long-term clinical outcomes of patients (pts) with peri-procedural myocardial infarction (P-MI) with those without P-MI following percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) in real world clinical practice. Methods: A total of 1119 pts underwent PCI with DESs between 2004 and 2010 were enrolled (control group, n=1006 pts and P-MI group, n=113 pts). P-MI was defined as major CK-MB elevation (���3X the upper limit of normal [ULN]) after PCI. Results: There were no significant differences between the two groups except P-MI group was more elderly, had more female, longer procedure time, higher number of target vessel and stents. At 6 month routine follow-up angiography, there was no significant difference in mean diameter stenosis %, incidence of binary restenosis and late loss between the two groups. Among the major in-hospital outcomes, cardiac death was higher in P-MI group. At 2-year (follow-up, 89.1%), and the cumulative incidence of total death, cardiac death and total major adverse cardiac events (MACEs) were higher in P-MI group, where as repeat PCI including target lesion revascularization (TLR) and target vessel revascularization (TVR). However, when in-hospital mortality was excluded, the major clinical outcomes were not different between the two groups up to 2 years (table). Conclusions: P-MI was mainly associated with in-hospital cardiac death following PCI with DES in real world clinical practice. However, P-MI doesn���t seem to be an independent predictor for adverse clinical outcomes for long-term period.