Chelation Therapy for Cardiovascular Disease: Bringing it Back to the Future

Chelation therapy, a treatment long undervalued by conventional medicine, has been used by alternative medicine practitioners to alleviate various metabolic toxicities. In particular, there has been significant controversy around its use in patients with coronary artery disease. We performed a focused review of the recent National Institute of Health (NIH) trial to investigate the role of chelation therapy in the treatment of patients with coronary artery disease. The study was the first randomized, factorial trial (n=1708) in patients with coronary artery disease, already receiving standard, guideline-approved treatment. Patients were randomized to EDTA chelation therapy with or without oral multivitamin multimineral supplement (OMVM). The trial showed that EDTA chelation reduced the primary endpoint (a composite of total mortality, recurrent myocardial infarction, stroke, coronary revascularization, or hospitalization for angina) by 18% overall (95% confidence interval [CI]: 1‐21%). This benefit was increased by addition of OMVM (26% relative reduction; 95% CI: 5‐23%), and the effect was most pronounced in patients with diabetes: 51% (95% CI: 25‐67%) relative reduction for chelation with, and 41% (95% CI: 21‐56%) without OMVM, respectively. Chelation therapy, recently evaluated in the NIH trial of patients with coronary artery disease, has been given a class IIb (may be beneficial) designation by the American College of Cardiology Chronic Ischemic Heart Disease Guidelines. The positive and significant impact of chelation therapy on morbidity and mortality of patients already receiving standard contemporary treatment is pivotal to the advancement of chelation therapy into the mainstream of coronary artery disease treatments.