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J Am Coll Cardiol. 2016 May 24;67(20):2411-2418. doi: 10.1016/j.jacc.2016.02.066.

Heavy Metals, Cardiovascular Disease, and the Unexpected Benefits of Chelation Therapy.

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Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami Beach, Florida. Electronic address:
John Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Duke Clinical Research Institute, Durham, North Carolina.


This review summarizes evidence from 2 lines of research previously thought to be unrelated: the unexpectedly positive results of TACT (Trial to Assess Chelation Therapy), and a body of epidemiological data showing that accumulation of biologically active metals, such as lead and cadmium, is an important risk factor for cardiovascular disease. Considering these 2 areas of work together may lead to the identification of new, modifiable risk factors for atherosclerotic cardiovascular disease. We examine the history of chelation up through the report of TACT. We then describe work connecting higher metal levels in the body with the future risk of cardiovascular disease. We conclude by presenting a brief overview of a newly planned National Institutes of Health trial, TACT2, in which we will attempt to replicate the findings of TACT and to establish that removal of toxic metal stores from the body is a plausible mechanistic explanation for the benefits of edetate disodium treatment.


cadmium; coronary artery disease; lead; metal intoxication; myocardial infarction

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