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A TACTful reappraisal of chelation therapy in cardiovascular disease

Nature Reviews Cardiology volume 11, pages 180–183 (2014)Cite this article

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Abstract

Atherosclerotic cardiovascular disease (CVD) is highly prevalent and, despite therapeutic advances, remains a leading cause of morbidity and mortality. Many patients with CVD seek additional alternative therapies when symptoms are not controlled with evidence-based therapies. Although its therapeutic efficacy is unproven, chelation therapy with ethylenediamine tetra acetic acid (EDTA) is increasingly being used in patients with CVD. Early studies of chelation in atherosclerotic CVD provided the basis for the randomized Trial to Assess Chelation Therapy (TACT), in which chelation with disodium EDTA was compared with placebo in patients who had experienced a myocardial infarction. Here, we discuss the results, limitations, and implications of TACT in the context of other studies in the field. We believe that the findings from TACT are not robust and do not marshal evidence in support of the potential clinical use of chelation therapy for CVD, with the potential exception of certain high-risk cohorts such as patients with diabetes mellitus. Therefore, chelation is unlikely to become a widely-accepted approach until additional data are available.

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  1. Division of Cardiology, Department of Medicine, Albany Stratton Veteran's Affairs Medical Centre and Albany Medical College, 113 Holland Avenue, Albany, 12208, NY, USA

    Mandeep S. Sidhu, Basil M. Saour & William E. Boden

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  1. Mandeep S. Sidhu
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  2. Basil M. Saour
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Contributions

M. S. Sidhu and B. M. Saour researched data for the article. M. S. Sidhu and W. E. Boden both made substantial contributions to the discussion of content. M. S. Sidhu, B. M. Saour, and W. E. Boden wrote the article and edited/reviewed the content before submission.

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Correspondence to William E. Boden.

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The authors declare no competing financial interests.

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Sidhu, M., Saour, B. & Boden, W. A TACTful reappraisal of chelation therapy in cardiovascular disease. Nat Rev Cardiol 11, 180–183 (2014). https://doi.org/10.1038/nrcardio.2013.176

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