Background
CABG, BMS and DES have become the most popular interventions in patients with pure multi-vessel disease. 

Objectives
To compare the clinical and economic consequences of the interventions and during the first year after the intervention, in patients with pure multi-vessel disease who were treated by CABG, BMS and DES.

Methods
349 patients were identified – 180 underwent CABG, 52 – DES and 117 – BMS. All of them were treated in Shearei Zedek Medical Center between 1/2002 and 2/2006, and were members of Meuhedet sickness fund and Clalit health Services. Data on medical care consumed and costs were retrieved from the medical records at the sickness funds. Socioeconomic and self reported health (SF36) data were collected by telephone interviews.

Main findings
The total cost of the procedures and during the first year thereafter were: CABG – 59,194 NIS, BMS – 44,518 NIS and DES- 40,164 NIS.  Total cardiac costs were 50,034 NIS, 39,825 NIS and 40, 164 NIS respectively. Costs were different in different population groups. Controlling for personal characteristics and morbidity, BMS and DES do not differ in their costs, and both were 32% cheaper than BABG. The means of the SF36 scales were 67 for CABG, 65 for BMS and 76 for DES. Controlling for personal characteristics and morbidity, however, no differences in health at the end of the first year were found.

Conclusions
CABG is the most costly procedure, DES is the least costly, with no difference in reported health and functioning. There are marked differences in relative costs among the different population groups. Before arriving at final conclusions and recommendations to policy makers, we need to better acount for the heterogeneity among the three populations, since more severe patients (with TVS, proximal disease, with hypertension and smokers) tend to be operated.

Research number: R/60/2005