Features June 2013 Issue

Chelation Therapy: Hope or Hype?

A controversial study does nothing to sway cardiologists’ opinions on this treatment involving the removal of heavy metals from the body.

Chelation therapy may be best known as a treatment for lead and mercury poisoning, but it has also been used to treat heart disease and even stroke. However, many health experts agree that chelation—the removal of heavy metals from the body with intravenous drugs—should not be a part of heart-health treatment.

A much-anticipated study, reported in a recent issue of the Journal of the American Medical Association (JAMA), appeared to show that chelation therapy may slightly reduce the risk of cardiovascular events. The study, known as the Trial to Assess Chelation Therapy (TACT), involved 1,708 patients at 134 centers across the U.S. and Canada. The study was sponsored by the National Center for Complementary and Alternative Medicine and the National Heart, Lung, and Blood Institute.

But Leslie Cho, MD, director of  the Women’s Cardiovascular Center and section head of Preventive Cardiology and Rehabilitation at Cleveland Clinic, echoes the sentiments of many cardiologists, who say there were too many problems with the study for it to change treatment practices. “This is a very problematic study,” she says, noting that a high number of patients withdrew before the study was completed, and that the study itself was compromised by limitations in its design and execution.

Steven Nissen, MD, chairman of the Department of Cardiovascular Medicine at Cleveland Clinic wrote an editorial accompanying the JAMA report, in which he also took issue with the way the study was conducted and the conclusions reached by investigators. “The findings of TACT should not be used as a justification for increased use of this controversial therapy,” he wrote.

How Chelation Therapy Works
In simplest terms, patients undergoing chelation therapy are given a chelating agent such as disodium ethylene diamine tetraacetic acid (EDTA), often through intravenous injection. The EDTA binds to heavy metals in the bloodstream and helps remove them from the body.

And though it has long been an effective means of treating patients suffering from mercury, lead or arsenic poisoning, it has also been touted as a treatment for cancer and heart disease, yet no conclusive studies have proven its effectiveness in treating those conditions. And in addition to being expensive, chelation therapy has also been associated with side effects such as kidney damage and arrhythmias. Chelation therapy has been used by practitioners of alternative medicine for many years to treat conditions ranging from arthritis and psoriasis to Alzheimer’s and diabetes. But evidence of its efficacy in treating heart disease is far from conclusive.

Bottom Line
“It should not change practice,” Dr. Cho reiterates. “It opens the door for more research but does not change how we should treat our patients, and we should not be recommending this treatment at this time… There is no way if this chelation was a drug, that it would pass FDA standards.” 

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