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Review
. 2016 Aug;14(8):927-38.
doi: 10.1080/14779072.2016.1180977. Epub 2016 May 5.

Chelation therapy to treat atherosclerosis, particularly in diabetes: is it time to reconsider?

Gervasio A Lamas  1 , Ian Ergui  1
Affiliations
Review

Chelation therapy to treat atherosclerosis, particularly in diabetes: is it time to reconsider?

Gervasio A Lamas et al. Expert Rev Cardiovasc Ther. 2016 Aug.

Abstract

Introduction: Case reports and case series have suggested a possible beneficial effect of chelation therapy in patients with atherosclerotic disease. Small randomized trials conducted in patients with angina or peripheral artery disease, however, were not sufficiently powered to provide conclusive evidence on clinical outcomes.

Areas covered: The Trial to Assess Chelation Therapy (TACT) was the first randomized trial adequately powered to detect the effects of chelation therapy on clinical endpoints. We discuss results and future research. Expert commentary: Chelation reduced adverse cardiovascular events in a post myocardial infarction (MI) population. Patients with diabetes demonstrated even greater benefit, with a number needed to treat of 6.5 patients to prevent a cardiac event over 5 years, with a 41% relative reduction in risk of a cardiac event (p = 0.0002). These results led to the revision of the ACC/AHA guideline recommendations for chelation therapy, changing its classification from class III to class IIb. TACT2, a replicative trial, will assess the effects of chelation therapy on cardiovascular outcomes in diabetic patients with a prior myocardial infarction. We are seeking participating sites for TACT2.

Keywords: Myocardial infarction; chelation; diabetes mellitus; edetate disodium; secondary prevention.

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Conflict of interest statement

Declaration of interest The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Figures

Figure 1
Figure 1
TACT- Kaplan-Meier Estimates of the Primary Composite Endpoint Chelation Therapy vs. Placebo
Figure 2
Figure 2
TACT- Kaplan Meier Estimates: placebo/placebo versus active/active (primary end point).
Figure 3
Figure 3
Primary end point in patients with a history (Hx) of diabetes mellitus.
Figure 4
Figure 4
Secondary end point in patients with diabetes mellitus.
Figure 5
Figure 5
Mortality in patients with diabetes mellitus by infusion group.
Figure 6
Figure 6
Present and Future Treatment of Environmental Metal Toxicants
See this image and copyright information in PMC

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