Chelation therapy in cardiovascular disease: an update

ABSTRACT

Introduction: The off-label use of chelation therapy (disodium edetate or EDTA) for prevention of cardiovascular disease (CVD) is widespread, despite the lack of convincing evidence for efficacy or approval from the Food and Drug Administration. After the publication of results from the National Institute of Health-sponsored Trial to Assess Chelation Therapy (TACT), a randomized controlled trial (RCT) in patients after myocardial infarction (MI), there is a renewed interest in clarifying the role of this treatment modality for patients with coronary artery disease.

Areas covered: This narrative review highlights the evidence from observational studies and RCT in assessing the effect of chelation therapy on cardiovascular outcomes and potential for adverse effects or harm.

Expert commentary: Although encouraging results were reported in TACT, the evidence is insufficient to recommend the routine use of chelation therapy even in the post-MI diabetic subgroup, which appeared to benefit. The ongoing TACT2 trial may clarify its use in post-MI diabetic patients. Unsubstantiated claims of chelation therapy as an effective treatment of atherosclerosis should be avoided and patients made aware of the inadequate evidence for efficacy and potential adverse effects, especially the harm that can occur if used as a substitute for proven therapies.

KEYWORDS:

• Atherosclerosis
• cardiovascular disease
• chelation
• edetate sodium
• Trial to Assess Chelation Therapy

Acknowledgments

We would like to thank Susan Nord and Jennifer Pfaff of Aurora Cardiovascular Services for their help with the manuscript and Brian Miller and Brian Schurrer of Aurora Research Institute for their help with the figures.

Declaration of interest

The authors have no 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. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded. Part of Arshad Jahangir’s time was supported by a grant (RO1-HL101240) from the National Institutes of Health.