Chelation for Coronary Heart Disease
Coronary heart disease is a leading cause of death among both men and women in the United States. Lifestyle changes (such as quitting smoking), medicines, medical and surgical procedures, and cardiac rehabilitation (a program consisting of education, counseling, and exercise training) are among the mainstays of conventional treatment. Some heart patients also turn to chelation therapy using disodium EDTA (ethylene diamine tetra-acetic acid), a controversial complementary health approach. The use of disodium EDTA for heart disease has not been approved by the U.S. Food and Drug Administration (FDA). Nevertheless, about 111,000 adults in the United States used chelation therapy as a form of complementary medicine in the previous 12 months, according to a 2007 national survey.
Chelation is a chemical process in which a substance is used to bind molecules, such as metals or minerals, and hold them tightly. Chelation has been used to rid the body of excess or toxic metals. It has some uses in conventional medicine, such as treating lead poisoning or iron overload. When used as a complementary treatment for heart disease, a health care provider typically administers a solution of disodium EDTA, a man-made amino acid, in a series of infusions through the veins. A course of treatment can require 30 or more infusions of several hours each, taken weekly until the maintenance phase. Patients also typically take high-dose pills of antioxidant vitamins and minerals.
To determine whether chelation therapy, with or without high-dose vitamins and minerals, may be useful, NCCIH and the National Heart, Lung, and Blood Institute sponsored the Trial to Assess Chelation Therapy (TACT), the first large-scale, multicenter clinical trial on chelation therapy in people who have had heart attacks.
- Overall, TACT showed that infusions of disodium EDTA chelation therapy produced a modest reduction in cardiovascular events. However, further examination of the data showed that chelation therapy benefitted only the patients with diabetes.
- Patients with diabetes, who made up approximately one-third of the 1,708 TACT participants, had a 41 percent overall reduction in the risk of any cardiovascular event; a 40 percent reduction in the risk of death from heart disease, nonfatal stroke, or nonfatal heart attack; a 52 percent reduction in recurrent heart attacks; and a 43 percent reduction in death from any cause. In contrast, there was no significant benefit of EDTA treatment in participants who didn’t have diabetes.
- The TACT study team also looked at the impact of taking high-dose vitamins and minerals in addition to chelation therapy. They found that chelation plus high-dose vitamins and minerals produced the greatest reduction in risk of cardiovascular events versus placebo.
- Further research is needed to fully understand the TACT results. Since this is the first clinical trial to show a benefit, these results are not, by themselves, sufficient to support the routine use of chelation as a post-heart attack therapy in people with diabetes.
- A new study, called the Trial To Assess Chelation Therapy 2 (TACT2), is now in its early stages. Its purpose is to repeat the first TACT study—but only in patients with diabetes and a prior heart attack—to see if the apparent benefit can be confirmed. The results of TACT2 will help the FDA determine whether disodium EDTA chelation therapy should be approved to reduce the risk of further cardiovascular events in patients who have both coronary artery disease and diabetes.
- In the TACT study, which had extensive safety monitoring, 16 percent of people receiving chelation and 15 percent of people receiving the placebo stopped their infusions because of an adverse event. Four of those events were serious; two were in the chelation group (one death) and two were in the placebo group (one death).
- The most common side effect of EDTA chelation is a burning sensation where the solution is placed the vein. Rare side effects can include fever, headache, nausea, and vomiting. Even more rare are serious and potentially fatal side effects that can include heart failure, a sudden drop in blood pressure, abnormally low calcium levels in the blood (hypocalcemia), permanent kidney damage, and bone marrow depression (blood cell counts fall). Hypocalcemia and death may occur particularly if disodium EDTA is infused too rapidly. Reversible injury to the kidneys, although infrequent, has been reported with EDTA chelation therapy. Other serious side effects can occur if EDTA is not administered by a trained health professional.
- If you’re considering chelation therapy, discuss it first with your cardiologist or other health care provider for your heart care. Seek out and consider information available from scientific studies on the therapy.
- If you decide to use chelation, choose the practitioner carefully (see the NCCIH tips on selecting a complementary health practitioner). Don’t take over-the-counter products marketed for “chelation” purposes.
- Give all your health care providers a full picture of what you do to manage your health. This will help ensure coordinated and safe care.
For more information on treating heart disease and on chelation therapy, see the resources below.
Questions and answers about two trials of an EDTA (ethylene diamine tetra-acetic acid) chelation therapy regimen for coronary heart disease–Trial to Assess Chelation Therapy (TACT) and Trial to Assess Chelation Therapy 2 (TACT2).
This page last modified November 20, 2018