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Chelation Therapy in Patients With Cardiovascular Disease: A Systematic Review

Journal of the American Heart Association, 2022-03, Vol.11 (6), p.e024648 [Peer Reviewed Journal]

2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. ;ISSN: 2047-9980 ;EISSN: 2047-9980 ;DOI: 10.1161/JAHA.121.024648 ;PMID: 35229619

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  • Title:
    Chelation Therapy in Patients With Cardiovascular Disease: A Systematic Review
  • Author: Ravalli, Filippo ; Vela Parada, Xavier ; Ujueta, Francisco ; Pinotti, Rachel ; Anstrom, Kevin J ; Lamas, Gervasio A ; Navas-Acien, Ana
  • Subjects: Adult ; cardiovascular disease ; Cardiovascular Diseases - drug therapy ; Chelation Therapy - methods ; diabetes ; Edetic Acid - therapeutic use ; EDTA ; Humans ; Prospective Studies ; Quality of Life ; Randomized Controlled Trials as Topic ; Retrospective Studies ; systematic review ; Systematic Review and Meta‐analysis
  • Is Part Of: Journal of the American Heart Association, 2022-03, Vol.11 (6), p.e024648
  • Description: Background EDTA is an intravenous chelating agent with high affinity to divalent cations (lead, cadmium, and calcium) that may be beneficial in the treatment of cardiovascular disease (CVD). Although a large randomized clinical trial showed benefit, smaller studies were inconsistent. We conducted a systematic review of published studies to examine the effect of repeated EDTA on clinical outcomes in adults with CVD. Methods and Results We searched 3 databases (MEDLINE, Embase, and Cochrane) from database inception to October 2021 to identify all studies involving EDTA treatment in patients with CVD. Predetermined outcomes included mortality, disease severity, plasma biomarkers of disease chronicity, and quality of life. Twenty-four studies (4 randomized clinical trials, 15 prospective before/after studies, and 5 retrospective case series) assessed the use of repeated EDTA chelation treatment in patients with preexistent CVD. Of these, 17 studies (1 randomized clinical trial) found improvement in their respective outcomes following EDTA treatment. The largest improvements were observed in studies with high prevalence of participants with diabetes and/or severe occlusive arterial disease. A meta-analysis conducted with 4 studies reporting ankle-brachial index indicated an improvement of 0.08 (95% CI, 0.06-0.09) from baseline. Conclusions Overall, 17 studies suggested improved outcomes, 5 reported no statistically significant effect of treatment, and 2 reported no qualitative benefit. Repeated EDTA for CVD treatment may provide more benefit to patients with diabetes and severe peripheral arterial disease. Differences across infusion regimens, including dosage, solution components, and number of infusions, limit comparisons across studies. Additional research is necessary to confirm these findings and to evaluate the potential mediating role of metals. Registration URL: https://www.crd.york.ac.uk/; Unique identifier: CRD42020166505.
  • Publisher: England: John Wiley and Sons Inc
  • Language: English
  • Identifier: ISSN: 2047-9980
    EISSN: 2047-9980
    DOI: 10.1161/JAHA.121.024648
    PMID: 35229619
  • Source: GFMER Free Medical Journals
    MEDLINE
    PubMed Central
    Wiley Online Library Open Access
    ROAD: Directory of Open Access Scholarly Resources
    DOAJ Directory of Open Access Journals
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