Complementary Alternative Cardiovascular Medicine

198 Alternative Cardiovascular Medicine
Table 1
Contraindications to EDTA Chelation Therapy
1. Acute coronary syndromes
2. Acute limb ischemia
3. Severe left ventricular dysfunction, with left ventricular ejection
fraction < 30%
4. Angiographic indications for coronary revascularization (left main, twovessel
with proximal LAD, and three-vessel with left ventricular
dysfunction)
5. Serum creatinine > 2.5 mg/dL
6. Pregnancy
7. Active hepatic disease
8. Allergy to ethylene diamine tetraacetic acid
patients may benefit from it. Conversely, if EDTA chelation were without
clinical merit, then physicians, administrators, and regulatory authorities
would be able to reject it on solid scientific evidence. The few
double-blind, prospective trials that have been performed were either
underpowered or methodologically flawed. The general acceptance of
EDTA chelation therapy in treating CVDs will need more rigorously
designed clinical studies to establish its efficacy and safety. Fortunately,
a large multicenter trial Trial to Assess Chelation Therapy (TACT) has
been initiated by the National Institutes of Health to assess the effects of
EDTA chelation on quality of life, clinical outcomes, cost-effectiveness,
and plasma markers of oxidative stress and endothelial dysfunction.
Until such a trial is completed, physicians can intelligently counsel patients
inquiring about EDTA chelation therapy by adhering to the guidelines
presented.
REFERENCES
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