Background: Patients with drug-eluting stents (DESs) overlap are at greater risk of experiencing major adverse cardiac events (MACE), particularly in terms of need of repeat revascularization and mortality. The aim of this study was to compare safety and efficacy of 4 homogenous overlapping DESs in acute myocardial infarction (AMI) patients. Methods: We selected 1,349 consecutive patients (mean age 62.1±14.9 years, 69.4% male) who received homogenous overlapping stents in diffuse de novo coronary lesions from Korea Acute Myocardial Infarction Registry from Apr. 2006 through Sep. 2010. They were divided into 4 groups based on type of DESs implanted - Paclitaxel (PES), Sirolimus (SES), Zotarolimus (ZES) and Everolimus (EES)-eluting stents. Primary endpoint was 12-month MACE. We also studied EES versus other DESs (PES+SES+ZES). Results: Mean stent length was 26.2±7.5mm and mean stent diameter was 3.1±0.4mm. Average number of stents used per vessel was 2.2±0.5. Incidence of MACE in PES, SES, ZES and EES groups were 9.5%, 9.2%, 7.5% and 3.8% respectively (p=0.013). In EES group, overall MACE and repeat revascularization were lowest, and no incidence of stent thrombosis was observed. Non-fatal MI was highest in PES, almost similar in SES and EES with no incidence in ZES group, p=0.044. Cox proportional hazard analysis revealed no differences in the incidence of primary endpoint (p=0.409). When EES was directly compared to other DESs (PES+SES+ZES) 12-month MACE differed significantly between 2 groups (HR5.052, 1.176-21.702, p=0.029). Conclusion: EES showed lowest incidence of MACE and TLR-driven repeat revascularization among the DESs studied.