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Expert Rev Cardiovasc Ther. 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?

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a The Columbia University Division of Cardiology at Mount Sinai Medical Center , Miami Beach , FL , USA.



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.


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.


Myocardial infarction; chelation; diabetes mellitus; edetate disodium; secondary prevention

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