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Chelation Therapy

By

Denise Millstine

, MD, Mayo Clinic

Medically Reviewed Oct 2021 | Modified Sep 2022
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Chelation therapy with EDTA (ethylene diamine tetraacetic acid) has also been suggested as a way to remove calcium and thus treat atherosclerosis. However, despite > 50 yr of study, researchers have not identified any mechanism to explain how chelation therapy could treat atherosclerosis or prevent heart attacks or strokes.

In 2012, a large randomized, placebo-controlled trial of chelation (the Trial to Assess Chelation Therapy [TACT]) found a significant benefit for chelation over placebo for composite outcomes (26.5% versus 30% for placebo), but not for individual outcomes (eg, death, cardiovascular events, stroke, hospitalizations) (4 References In chelation therapy, a biologically based practice, a drug is used to bind with and remove hypothesized excess or toxic amounts of a metal or mineral (eg, lead, copper, iron, calcium) from... read more ). This study had methodological flaws and did not end the controversy over chelation therapy; however, a post-hoc review of the data showed a significant reduction in the composite endpoint in patients with diabetes and peripheral artery disease in the chelation group compared to the control group, as well as a reduction in mortality (5 References In chelation therapy, a biologically based practice, a drug is used to bind with and remove hypothesized excess or toxic amounts of a metal or mineral (eg, lead, copper, iron, calcium) from... read more ).

A subsequent systematic review of 38 studies showed possible but unclear benefits of chelation in regard to secondary prevention of recurrent cardiac events (6 References In chelation therapy, a biologically based practice, a drug is used to bind with and remove hypothesized excess or toxic amounts of a metal or mineral (eg, lead, copper, iron, calcium) from... read more ).

Risks of chelation therapy include

  • Hypocalcemia (which is potentially serious)

  • Infusion site reaction, fever, nausea, vomiting

  • Kidney damage

  • Delay of more effective treatment

  • Death

References

  • 1. Killin LO, Starr JM, Shiue IJ, et al: Environmental risk factors for dementia: a systematic review. BMC Geriatr 16(1):175, 2016. doi: 10.1186/s12877-016-0342-y

  • 2. Chowdhury R, Ramond A, O'Keeffe LM, et al: Environmental toxic metal contaminants and risk of cardiovascular disease: systematic review and meta-analysis. BMJ 362:k3310, 2018. doi: 10.1136/bmj.k3310

  • 3. Farkhondeh T, Naseri K, Esform A, et al: Drinking water heavy metal toxicity and chronic kidney diseases: a systematic review. Rev Environ Health. 2020 Nov 2:/j/reveh.ahead-of-print/reveh-2020-0110/reveh-2020-0110.xml. doi: 10.1515/reveh-2020-0110

  • 4. Lamas GA, Goertz C, Boineau R, et al: Effect of disodium EDTA chelation regimen on cardiovascular events in patients with previous myocardial infarction: the TACT randomized trial. JAMA. 309(12):1241–50, 2013. doi: 10.1001/jama.2013.2107

  • 5. Ujueta F, Arenas IA, Escolar E, et al: The effect of EDTA-based chelation on patients with diabetes and peripheral artery disease in the Trial to Assess Chelation Therapy (TACT). J Diabetes Complications 33(7):490-494, 2019. doi: 10.1016/j.jdiacomp.2019.04.005

  • 6. Ibad A, Khalid R, Thompson PD, et al: Chelation therapy in the treatment of cardiovascular diseases. J Clin Lipidol 10(1):58-62, 2016. doi: 10.1016/j.jacl.2015.09.005

Drugs Mentioned In This Article

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