Background: Even though some article was reported that triple anti-platelet therapy was improved clinical outcomes and reduce the incidence of major adverse cardiac events (MACE) in acute coronary syndrome (ACS), little is known about the effect of triple anti-platelet therapy in acute myocardial infarction (AMI) accompany with non-diabetic renal insufficiency. Methods: We analyzed 1,280 patients in AMI with non-diabetic renal insufficiency who survived at discharge from the Korea Working Group on Myocardial infarction. Renal insufficiency defined as GFR<60mL/min/1.73m2 to be calculated by the Modification of Diet in Renal Disease (MDRD) study equation. They were divided to two groups according to the prescription of triple anti-platelet therapy at discharge (triple group; n=262, Non-triple group; n=1018). The primary end point was the composite of 1-year major adverse cardiac events including death, recurrent myocardial infarction (MI), target vessel revascularization and coronary artery bypass grafting. Results: Patients prescribed triple anti-platelet therapy for discharge medication were likely to have more left ventricular ejection fraction(49.73% vs. 52.78%, p=0.001), pre TIMI flow 0, DES, stent length stent number and post TIMI flow 3 in clinical and angiographic characteristics. Triple anti-platelet therapy was not significantly reduced the risk of the composite the primary end point (19.1% vs. 22.0%, p=0.353) with cardiac death, non-cardiac death, nonfatal MI, Revascularization, cardiac artery bypass graft (CABG). Conclusions: In AMI patients with non-diabetic renal insufficiency, triple anti-platelet therapy seemed to have no additional benefits than dual anti-platelet therapy. However, further randomized trials are needed.