Objectives: Central obesity in patients with coronary artery disease is directly related with adverse cardiovascular events. The aims of this study were to examine the association of truncal fat accumulation with outcomes after percutaneous coronary intervention (PCI). Methods: In 782 patients (mean age: 60 짹 11 years, 494 male, 63.2%) who underwent PCI for 840 coronary lesions with DES between January 2005 and June 2008, dual-energy X-ray absorptiometry (DXA) was performed to assess total body fat and regional body fat distribution. The primary outcome was defined as a composite of major adverse cardiac events (MACE) including cardiac death, myocardial infarction, and ischemia-driven target vessel revascularization (TVR). Results: During a median follow-up of 54 months, 82 cases of MACE (12 cardiac death, 2 myocardial infarction and 72 TVR) occurred. Percentage truncal fat mass to both legs fat mass ratio (%FMtrunk/FMleg) (2.5 vs 2.2, p=0.001) were higher in MACE group than no MACE group. To determine independent risk factors for MACE, we performed multiple logistic regression analysis and revealed that %FMtrunk/FMleg was an adjusted risk factor for adverse cardiac events after PCI (p=0.011), but not BMI, total fat mass. Conclusion: Poor outcome after PCI with DES is more associated with %FMtrunk/FMleg representing central body fat distribution than other obesity parameters, such as BMI. Therefore patients who had coronary angioplasty with DES might need to have therapeutic intervention for secondary prevention,