Subsequent Cardiac and Stroke Events in Patients with Known Vascular Disease Treated with EDTA Chelation Therapy

Dr L. Terry Chappell, Rakesh Shukla, Jun Yang, René Blaha, Tammy Born, Claus Hancke, William Mitchell, Efrain Olszewer, Peter van der Schaar, James Ventresco;

Chappell23 Aug 2012

Context

Myocardial infarction (MI) and strokes are leading causes of death in the US. Surgical and medical treatments can be helpful, but carry risks of morbidity and mortality.

Objective

To evaluate whether cardiac events were reduced for patients with known vascular disease who were treated with intravenous ethylene diamine tetra-acetic acid (EDTA) chelation therapy.

Design

Retrospective study with a 3-year follow-up, compared with similar patient groups by use of meta-analysis.

Population and setting

A total of 220 consecutive patients with known vascular disease were treated with chelation therapy during 1992–2001. Eight outpatient centres were included: five from the US and one each from Denmark, the Netherlands and Brazil. Average patient age was 64 years, 72.3% were males and 18.2% were smokers. Average number of treatments was 58.

Main outcome measures

MI, stroke and death from any cause were primary outcome measures. Secondary measures were resolution of symptoms and need for coronary artery bypass surgery (CABG) and percutaneous transluminal coronary angioplasty.

Results

According to the meta-analysis, expected outcomes in a 3-year follow-up period for 220 patients with coronary artery disease treated only with conventional therapies would be 15 MIs and six deaths. There were no deaths and no MIs in this group of patients who received chelation therapy. Four patients had strokes but recovered well. There were two angioplasties and six CABG procedures. Compared with similar patient populations treated with conventional therapies, patients who also were chelated had a 93.6% lesser need for angioplasty and a 62.5% reduced need for CABG. Of the patients that initiated treatment with symptoms, 68.7% had complete resolution of symptoms.

Conclusions

This study indicates that the administration of intravenous EDTA chelation therapy for patients with vascular disease resulted in fewer subsequent cardiac events than primary treatment with CABG, angioplasty or conventional medical therapy. EDTA chelation therapy for vascular disease is a reasonable, off-label adjunct, especially for patients who refuse or are not eligible for surgery. Clinical trials such as the Trial to Assess Chelation Therapy (TACT) are needed for definitive proof.

For full-text PDF, click here

 

Blood lead below 0.48 micromol/L (10 microg/dL) and mortality among US adults.

Menke A1, Muntner P, Batuman V, Silbergeld EK, Guallar E.

Abstract

Background— Blood lead levels above 0.48 μmol/L (10 μg/dL) in adults have been associated with increased risk of cardiovascular, cancer, and all-cause mortality. The objective of the present study was to determine the association between blood lead levels below 0.48 μmol/L and mortality in the general US population.

Methods and Results— Blood leadlead-1565598-640x480 levels were measured in a nationally representative sample of 13 946 adult participants of the Third National Health and Nutrition Examination Survey recruited in 1988 to 1994 and followed up for up to 12 years for all-cause and cause-specific mortality. The geometric mean blood lead level in study participants was 0.12 μmol/L (2.58 μg/dL). After multivariate adjustment, the hazard ratios (95% CI) for comparisons of participants in the highest tertile of blood lead (≥0.17 μmol/L [≥3.62 μg/dL]) with those in the lowest tertile (<0.09 μmol/L [<1.94 μg/dL]) were 1.25 (1.04 to 1.51; Ptrend across tertiles=0.002) for all-cause mortality and 1.55 (1.08 to 2.24; Ptrend across tertiles=0.003) for cardiovascular mortality. Blood lead level was significantly associated with both myocardial infarction and stroke mortality, and the association was evident at levels >0.10 μmol/L (≥2 μg/dL). There was no association between blood lead and cancer mortality in this range of exposure.

Conclusions— The association between blood lead levels and increased all-cause and cardiovascular mortality was observed at substantially lower blood lead levels than previously reported. Despite the marked decrease in blood lead levels over the past 3 decades, environmental lead exposures remain a significant determinant of cardiovascular mortality in the general population, constituting a major public health problem.

http://circ.ahajournals.org/content/114/13/1388.long