WJB Dorn VA Medical Center, and University of South Carolina School of Medicine, Columbia, SC, USA.
Albany Medical Center, Albany, NY, USA.
Cardiovasc Drugs Ther. 2017 Dec;31(5-6):619-625. doi: 10.1007/s10557-017-6759-5.
Chelation therapy, typically used to remove heavy metal toxins, has also been controversially used as a treatment for coronary artery disease. The first Trial to Assess Chelation Therapy (TACT) aimed to provide evidence on chelation therapy's potential for benefit or harm. Although TACT had some significant results, the trial does not provide enough evidence to recommend routine chelation therapy and has limitations. The second TACT was recently funded reigniting a discussion about the value of chelation therapy, its efficacy, and allocation of research resources. Despite limited evidence, patients continue to pursue chelation therapy as a treatment for coronary artery disease. As the medical community has a responsibility to understand all treatments patients pursue, it is important to comprehensively appraise chelation therapy for cardiovascular disease. Understanding the background of heavy metal toxicity, the putative target of chelation therapy, on the cardiovascular system is important to contextualize the role of chelation therapy in cardiovascular disease prevention. We review the clinical evidence of heavy metal toxicity and cardiovascular disease, and available clinical trial data on use of chelation therapy to minimize the cardiovascular burden of heavy metal toxicity.
螯合疗法，通常用于去除重金属毒素，也被有争议地用于治疗冠状动脉疾病。评估螯合疗法的首次试验（TACT）旨在提供关于螯合疗法潜在益处或危害的证据。尽管 TACT 有一些重要的结果，但该试验没有提供足够的证据来推荐常规螯合疗法，并且存在局限性。最近，第二个 TACT 获得了资金，重新引发了关于螯合疗法的价值、疗效和研究资源分配的讨论。尽管证据有限，但患者仍继续将螯合疗法作为治疗冠状动脉疾病的一种方法。由于医学界有责任了解患者所追求的所有治疗方法，因此全面评估螯合疗法治疗心血管疾病非常重要。了解重金属毒性的背景、螯合疗法对心血管系统的假定靶点，对于将螯合疗法在心血管疾病预防中的作用置于上下文中非常重要。我们回顾了重金属毒性和心血管疾病的临床证据，以及关于使用螯合疗法减轻重金属毒性对心血管系统负担的现有临床试验数据。
