Background: Data for long-term serial change of luminal diameter after drug-eluting stents (DES) are limited. To evaluate these pattern of different DES, we analyzed serial follow-up of angiographic outcomes of zotarolimus-eluting stents (ZES), sirolimus-eluting stents (SES), and paclitaxel-eluting stents (PES) groups in the ZEST trial. Method: In the ZEST trial, patients were randomized to receive ZES, SES or PES in a 1:1:1 fashion. Complete after-procedure, 9-month, and 2-year angiographic data were available in 111 patients with 165 lesions (36, 40, and 35 patients, respectively). Results: Baseline clinical, angiographic, and procedural characteristics were similar among the three groups. Quantitative angiographic analysis revealed a significant decrease in minimal luminal diameter from stent implantation to 9 months in all groups (from 2.71 짹 0.49 mm to 2.21 짹 0.42 in ZES group, p<0.001; from 2.79 짹 0.49 mm to 2.58 짹 0.57 mm in SES group, p<0.001; from 2.66 짹 0.45 mm to 2.19 짹 0.52 mm in PES group, p<0.001). However, significant late improvement in luminal diameter was observed between 9 months and 2 years in all groups with different degree of luminal change (from 2.21 짹 0.42 mm to 2.39 짹 0.58 mm in ZES group, p=0.001; from 2.58 짹 0.57 mm to 2.66 짹 0.60 mm in SES group, p=0.039; from 2.19 짹 0.52 mm to 2.43 짹 0.52 mm in PES group, p<0.001) (Figure). Conclusion: Serial angiographic analysis for up to 2 years in the ZEST trial revealed a biphasic luminal response characterized by an early progression phase until 9 months and late regression phase from 9 months to 2 years with different degree after DES implantation.