Those with complications (13.6% of patients) consumed significantly more hospital resources (incremental cost, $15 468) and had a longer length of stay (average additional Evidence for the role of off-pump versus on-pump CABG in decreasing costs is conflicting. In a randomized study comparing off-pump and on-pump CABG, the mean total hospitalization cost per patient was $2272 less for off-pump CABG at hospital discharge and $1955 less at 1 year.1248 Another study of 6665 patients who underwent CABG between 1999 and 2005 determined that off-pump CABG provided a small short-term gain,1249 although off-pump patients had increased long-term risks of repeat revascular- ization and major vascular events, especially if they were considered to be high risk. In the long run, in fact, off-pump patients utilized more resources. 7.1.1. Cost-Effectiveness of CABG Versus PCI Medical costs and quality of life were examined 10 to 12 years after patients were randomly assigned to receive angio- plasty or CABG in the BARI trial.1250 Although CABG costs initially were 53% higher, the gap closed to 5% by the end of 2 years. After 12 years, the average cost was $123 000 in CABG patients and $120 000 for PCI patients. Cumulative costs were significantly higher among patients with diabetes mellitus, heart failure, and comorbid conditions, and they were higher in women. CABG was deemed to be as cost- effective as PCI in patients with multivessel CAD. The cost of coronary artery revascularization in 6218 patients with and without CKD whose data were available in the Duke database was examined.1251 CABG was an economically attrac- tive alternative to PCI or medical therapy for all patients with left main or 3-vessel CAD without concomitant CKD as well as those with 2-vessel CAD with concomitant CKD. 