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静脉螯合疗法降低钙评分:一项回顾性初步研究

Reduction of Calcium Scores Using Intravenous Chelation: A Retrospective Pilot Study.

作者信息

Petteruti Stephen J, Frazzini Vincent

机构信息

Family Medicine, Kent County Memorial Hospital, Warwick, USA.

Radiology, Tollgate Radiology, Warwick, USA.

出版信息

Cureus. 2023 Sep 4;15(9):e44657. doi: 10.7759/cureus.44657. eCollection 2023 Sep.

Abstract

This pilot study presents a retrospective analysis of 10 asymptomatic patients with a positive calcium score who received a series of intravenous calcium ethylenediaminetetraacetic acid (EDTA) chelations. Current standards for cardiovascular risk stratification include assessments of cholesterol, blood pressure, blood sugar, lifestyle, obesity, and family history. Despite addressing traditional risk factors, myocardial infarctions and cerebrovascular accidents remain the leading causes of death and disability worldwide. Asymptomatic decay of the vascular system is a prelude to catastrophic events, and calcium scores are emerging as a significant adjunct for risk assessment. Positive calcium scores correlate with an increased risk of cardiovascular events. However, there are no therapies known to reliably reverse calcium scores. Previous studies have demonstrated that intravenous chelation therapy reduces cardiovascular morbidity and mortality in patients with a prior history of myocardial infarction; however, its mechanism of action is unknown. One theory is that chelation therapy would reverse calcium buildup in coronary arteries, which is known to have a positive correlation with the risk of having a cardiovascular event. The 10 patients had no prior history of coronary artery disease. Infusions were administered in an outpatient setting. Patients were encouraged to receive a treatment every month. No other supplements or prescriptions were required as part of the treatment. An average of 26.9 chelations were administered over an average of 37.9 months. Calcium scores decreased by an average of 27.38%, and all 10 patients experienced a reduction in scores.  This study demonstrates that chelation has the potential to reduce calcium scores. Since calcium scores correlate with cardiovascular risk, reducing the calcium score may reduce the risk of an event. If these results are supported by larger, placebo-controlled studies, chelation therapy may become an option that could be added to statins and other FDA-approved therapies for primary prevention in patients with a positive calcium score.

摘要

这项初步研究对10名无症状但钙评分呈阳性的患者进行了回顾性分析,这些患者接受了一系列静脉注射乙二胺四乙酸钙(EDTA)螯合治疗。目前心血管风险分层的标准包括对胆固醇、血压、血糖、生活方式、肥胖和家族病史的评估。尽管考虑了传统风险因素,但心肌梗死和脑血管意外仍然是全球范围内死亡和残疾的主要原因。血管系统的无症状衰退是灾难性事件的前奏,而钙评分正逐渐成为风险评估的重要辅助手段。阳性钙评分与心血管事件风险增加相关。然而,目前尚无已知疗法能可靠地逆转钙评分。先前的研究表明,静脉螯合疗法可降低有心肌梗死病史患者的心血管发病率和死亡率;但其作用机制尚不清楚。一种理论认为,螯合疗法可逆转冠状动脉中的钙沉积,而冠状动脉钙沉积与发生心血管事件的风险呈正相关。这10名患者既往无冠状动脉疾病史。输液在门诊进行。鼓励患者每月接受一次治疗。治疗过程中无需其他补充剂或处方。平均在37.9个月内进行了26.9次螯合治疗。钙评分平均下降了27.38%,所有10名患者的评分均有所降低。这项研究表明,螯合疗法有可能降低钙评分。由于钙评分与心血管风险相关,降低钙评分可能会降低事件发生风险。如果这些结果得到更大规模、安慰剂对照研究的支持,螯合疗法可能会成为一种可添加到他汀类药物和其他美国食品药品监督管理局(FDA)批准的疗法中的选择,用于对钙评分呈阳性的患者进行一级预防。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf0e/10549777/612ab349a810/cureus-0015-00000044657-i01.jpg

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