Thursday March 28, 2013
I'll bet this will make the lay press, so here is the truth. In JAMA (Journal of the American Medical Assn.) this week, there is the publication of a huge, long, extraordinarily expensive trial that evaluated chelation therapy in persons who had a previous heart attack. The bottom line is, it didn't work. But, that may not be what you read in the newspapers. 1,708 persons who had a heart attack were enrolled in this trial. Half got 40 infusions of EDTA [a chelating agent, i.e., one which binds various cations, such as calcium, magnesium, lead, etc.] and half were given placebo infusions. The patients were followed for 4 1/2 years. At the end of that time, there were 6 more deaths in the placebo group than in the EDTA group. This number is NOT of any statistical significance. There were 3 more strokes in the placebo group. This is NOT statistically of any significance. the placebo group had a few more heart attacks, need for revascularization (i.e., stents or bypass surgery) and need for hospitalization because of angina than did the EDTA group, but NONE of these differences was statistically significant. Nonetheless, JAMA permitted the authors to conclude "EDTA, compared with placebo, modestly reduced the risk of adverse cardiovascular outcomes." However, they were compelled to admit these findings were "not sufficient to support the routine use of chelation therapy for treatment of patients who have had an MI [myorcardial infarction or 'heart attack']." I suspect some of the media will turn conspiracy theorist and conclude, a - ha!, doctors don't want patients to get better so they're denying EDTA to peopel, etc. An accompanying editorial by Steve Nissen (Cleveland Clinic cardiologist), a guy who I know and is quite reasonable, points out the multiple methodological flaws in this trial (I won't bore you with the details) make interpretaion of the results questionable, at best, and he concludes his remarks with: "The findings of TACT [The Trial to Assess Chelation Therapy] should not be used as a justification for increased use of this controversial therapy." I have a hunch you are about to hear and read a bunch of b. s. about all this. Now you know the truth.