National Center for Complementary and Alternative Medicine (NCCAM)

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Chelation for Coronary Heart Disease

Coronary heart disease is the number-one killer of men and women in the United States. Lifestyle changes (such as quitting smoking), medicines, and medical and surgical procedures 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. Use of this therapy to treat heart disease and other diseases grew, however, in the United States from 2002 to 2007 by nearly 68 percent, to an estimated 111,000 people using it annually.

Chelation is a chemical process in which a substance is used to bind molecules, such as metals or minerals, and hold them tightly so that they can be removed from the body. 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 vitamins and minerals.

To determine whether chelation therapy, with or without high-dose vitamins and minerals, may be useful, NCCAM and the National Heart, Lung, and Blood Institute sponsored the first large-scale, multicenter clinical trial on chelation therapy in people with coronary heart disease. Results of the Trial to Assess Chelation Therapy (TACT) began to be released in 2013.

Bottom Line

  • Overall, TACT showed that infusions of EDTA chelation therapy produced a modest but statistically significant reduction in cardiovascular events in EDTA-treated participants. However, further examination of the data showed that patients with diabetes were significantly impacted by chelation therapy while patients without diabetes were not.
  • 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 did not have diabetes.
  • The TACT study team also looked at the impact of taking high-dose vitamins and minerals in addition to the 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 post-heart attack therapy.

Safety

  • 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 in the placebo group (one death).
  • The most common side effect of EDTA chelation is a burning sensation at the site where EDTA is administered. 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 (meaning that 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 NCCAM Time to Talk Tips on selecting a complementary health practitioner). Do not 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, visit the resources below.