Background: Nicorandil has cardiac protective effect in the ischemic myocardium because of ischemic preconditioning, reduced myocardial necrosis and improved coronary artery reperfusion. However, there are rare large studies whether nicorandil is effective in patient with ST segment elevation myocardial infarction(STEMI) and non ST segment elevation myocardial infarction(NSTEMI). Method: 6370 patients with STEMI in Korean Acute Myocardial Infarction Registry (KAMIR) were divided to two groups : a group with nicoranil(n=1,313, Group N) and a group without nicorandil(n= 5,057, Group C). We analyzed for death and myocardial infarction and composite of major adverse cardiac events (MACE) at 1, 6 and 12 month.Result: There are no differences of baseline characteristics, angiographic finding and medications in each group. At 1 month, Group N is significant low incidence of MACE, compared to Group C. (Composite MACE: 2.2% vs. 4.1%, p=0.001, Cardiac death: 1.1 vs. 1.8, p=0.068, MI: 0.1 vs. 0.5 p=0.019), At 6 month, Group N is also significant low incidence of MACE, compared to Group C. (Composite MACE: 8.1% vs. 10.1%, p=0.047, Cardiac death: 1.7 vs. 2.7, p=0.054, MI: 0.1 vs. 0.9 p=0.002), However, at 12 month, Group N is not significant difference in incidence of MACE, compared to Group C. MI is low in Group N.(Composite MACE: 13.8% vs. 15.1%, p=0.374, Cardiac death: 2.8 vs. 3.8, p=0.163, Myocardial infarction: 0.4 vs. 1.2 p=0.046). In patients with NSTEMI do not show difference of clinical outcomes at 1, 6, and 12 month.. Conclusion: Administration of nicorandil in patients with STEMI reduced MACE, cardiac death and MI. Nicorandil mainly improved short-term clinical outcome on the STEMI. But, Nicorandil didn���t have an effect on clinical outcome on the NSTEMI.