Lamas Gervasio A, Navas-Acien Ana, Mark Daniel B, Lee Kerry L
Columbia University Division of Cardiology at Mount Sinai Medical Center, Miami Beach, Florida.
John Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
J Am Coll Cardiol. 2016 May 24;67(20):2411-2418. doi: 10.1016/j.jacc.2016.02.066.
This review summarizes evidence from 2 lines of research previously thought to be unrelated: the unexpectedly positive results of TACT (Trial to Assess Chelation Therapy), and a body of epidemiological data showing that accumulation of biologically active metals, such as lead and cadmium, is an important risk factor for cardiovascular disease. Considering these 2 areas of work together may lead to the identification of new, modifiable risk factors for atherosclerotic cardiovascular disease. We examine the history of chelation up through the report of TACT. We then describe work connecting higher metal levels in the body with the future risk of cardiovascular disease. We conclude by presenting a brief overview of a newly planned National Institutes of Health trial, TACT2, in which we will attempt to replicate the findings of TACT and to establish that removal of toxic metal stores from the body is a plausible mechanistic explanation for the benefits of edetate disodium treatment.
螯合疗法评估试验(TACT)意外取得的积极结果,以及一系列流行病学数据表明,生物活性金属如铅和镉的蓄积是心血管疾病的重要危险因素。将这两个研究领域结合起来考虑,可能会识别出动脉粥样硬化性心血管疾病新的、可改变的危险因素。我们审视了螯合疗法直至TACT报告的历史。然后描述了将体内较高金属水平与未来心血管疾病风险联系起来的研究。最后,我们简要概述了美国国立卫生研究院新计划的一项试验——TACT2,在该试验中,我们将试图重现TACT的研究结果,并确定从体内清除有毒金属储备是依地酸钠治疗获益的一个合理机制解释。