Chelation Therapy for Heart Disease: The TACT and TACT2 Trials

Table of Contents

1. From Lead Wards to Heart Clinics
2. What the Infusions Contain
3. The Two Rationales and Who States Them
4. The Earlier Small Trials
5. TACT: The 2013 Trial
6. The Diabetes Subgroup and the Vitamin Arm
7. How the TACT Result Was Received
8. TACT2: The Repeat Trial in Diabetes
9. What the Pooled Reviews Found
10. Safety Findings
11. What Practitioners and Patients Report
12. What Is Not Known
13. Key Research Papers
14. Connections
15. Featured Videos

From Lead Wards to Heart Clinics

The drug at the centre of this story is ethylenediaminetetraacetic acid (EDTA), a synthetic molecule that wraps around metal ions so the kidneys can flush them out. It entered medicine in the late 1940s and 1950s as a treatment for lead poisoning. As the site's detox history article describes, it was during this lead-poisoning work, at Providence Hospital in Detroit, that the cardiologist Norman E. Clarke Sr. noticed in the early 1950s that some treated patients reported less angina (chest pain from a heart short of blood). In 1956 Clarke, a co-author of the same surname and Mosher published a report in the American Journal of the Medical Sciences titled "Treatment of angina pectoris with disodium ethylene diamine tetraacetic acid". That paper is the usual starting point given for chelation as a heart treatment.

What happened next is described in two quite different ways in the published record. A 2014 review written by the TACT investigators states that medical practitioners have treated atherosclerotic disease with chelation for over 50 years, that a lack of strong evidence led conventional practitioners to abandon it in the 1960s and 1970s, and that this left chelation to complementary and alternative medicine practitioners, who reported good anecdotal results. A 2008 critique of the trial, written before its results were known, states that a few case series in the 1950s and early 1960s had found disodium EDTA ineffective for coronary artery disease and for poor circulation in the legs, and that a few hundred physicians nevertheless continued to offer it as an office treatment.

Both sources agree on the outline: chelation for the arteries moved out of hospital cardiology and into office-based integrative clinics, where it was given as a course of weekly drips. The 2020 Cochrane review describes it as a therapy "promoted and practiced around the world as a form of alternative medicine". The TACT report itself opens by noting that chelation with disodium EDTA "has been used for more than 50 years to treat atherosclerosis without proof of efficacy". Because the practice continued without a trial to settle it, the National Institutes of Health issued a call for a definitive trial, which became TACT.

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What the Infusions Contain

Two different EDTA drugs exist, and the difference matters for safety (see Safety Findings):

• Edetate disodium (disodium EDTA) binds calcium as well as other metals, so it can pull calcium out of the blood. This is the form used in heart chelation and in both TACT trials.
• Edetate calcium disodium (calcium disodium EDTA) already carries calcium. It is the form used in hospitals for lead poisoning; the site's Lead and Heavy Metals Panel pages describe that use.

The TACT drip. Each infusion in TACT was a 500 mL bag containing 3 g of edetate disodium, 7 g of ascorbate (vitamin C), B vitamins, electrolytes, procaine (a local anaesthetic) and heparin (a blood thinner). The trial gave 40 infusions: one a week for 30 weeks, then 10 more spaced 2 to 8 weeks apart. The placebo group received drips that looked the same. TACT2 used the same kind of multi-component edetate disodium solution, given as 40 weekly infusions.

The oral regimen. Both trials had a second, separate experiment built in (a "2 × 2 factorial" design). Half the patients took an oral high-dose mixture of 28 vitamins and minerals and half took a look-alike placebo, independently of whether their drips were real. The trial gave six caplets a day; TACT2 gave them twice daily for up to 60 months. The vitamin results are covered in the next sections.

The earlier trials used similar ideas with different doses: the Danish leg-artery trial gave 20 infusions of 3 g edetate disodium over 5 to 9 weeks with oral vitamins, minerals and trace elements; the Canadian PATCH trial gave a weight-adjusted 40 mg per kg over 3 hours, twice weekly for 15 weeks and then monthly for 3 months, with oral multivitamins in both groups.

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The Two Rationales and Who States Them

The original rationale: calcium in plaque

As chelation practitioners have long explained it (this summary of their rationale is general background rather than taken from one of the papers below), the early idea was that edetate disodium binds calcium, that hardened arterial plaque contains calcium, and that repeated drips could therefore draw calcium out of the plaque and open the arteries. The 2020 Cochrane review records the claim in its general form: chelation "has been suggested as a safe, relatively inexpensive, non-surgical method of restoring blood flow in atherosclerotic vessels". A 2003 substudy of the PATCH trial records a related, later idea: that EDTA chelation has antioxidant properties and might improve the lining of the arteries.

The newer rationale: lead and cadmium

The TACT investigators and environmental-health researchers give a different reason. Edetate disodium has a strong grip on lead and cadmium, two metals that most people carry at low levels from air, water, soil and food. In 2023 the American Heart Association published a scientific statement, written by a panel that included TACT and TACT2 investigators, titled "Contaminant Metals as Cardiovascular Risk Factors". It states that accumulating evidence supports that exposure to lead, cadmium and arsenic is a significant contributor to cardiovascular disease worldwide; that these metals have been linked to atherosclerosis, narrowing and calcification of the coronary arteries, heart disease, stroke, heart failure and leg-artery disease; and that public-health measures that reduced metal exposure are associated with fewer cardiovascular deaths. The statement lists "the development of metal chelation therapies" among the steps that could further reduce metal-related heart disease.

Population studies behind that view include a U.S. cohort of 14,289 adults followed for a median of 19.3 years, in which a rise in blood lead from 1.0 to 6.7 µg/dL (the 10th to 90th percentile) was associated with a 70% higher rate of cardiovascular death (hazard ratio 1.70); the authors estimated about 256,000 cardiovascular deaths a year in the United States attributable to low-level lead. A 2016 pooled analysis of cohort studies found that people in the highest group for urinary cadmium had a 57% higher rate of cardiovascular death than those in the lowest (hazard ratio 1.57). These are associations in observational data. They do not by themselves show that removing the metal by chelation lowers risk, which is the question TACT2 was built to test. The site's Lead and Cadmium pages cover these metals in depth.

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The Earlier Small Trials

Before TACT, a handful of placebo-controlled trials had been run, most of them small and most of them in people with narrowed leg arteries rather than heart disease.

• The Danish trials (1991–1993). A double-blind multicentre trial gave 153 people with severe leg pain on walking (intermittent claudication) 20 infusions of either edetate disodium or placebo. Pain-free and maximum walking distances on a treadmill changed by similar amounts in both groups, no long-term effect was seen at 3 or 6 months, and the ankle-brachial index (a blood-pressure measure of leg circulation) stayed unchanged. A related Danish report on 153 claudication patients, 30 of whom had X-ray pictures of their arteries (angiograms) before, during and after treatment, concluded that the drips had no effect. A third report on 29 patients found no change in total, LDL or HDL cholesterol or triglycerides.
• PATCH (Calgary, 2002). The Program to Assess Alternative Treatment Strategies to Achieve Cardiac Health enrolled 84 people with stable angina and proven coronary artery disease. After 27 weeks, the time they could exercise on a treadmill before the heart showed signs of strain rose by 63 seconds in the chelation group and by 54 seconds in the placebo group, a difference of 9 seconds that was not statistically significant. Exercise capacity and quality-of-life scores improved by similar amounts in both groups. A substudy of 47 participants found no difference in how well the arm artery widened (flow-mediated dilation) after the first or the 33rd treatment.

These trials were small. None of them was large enough to measure heart attacks or deaths, which is why the National Institutes of Health funded a much larger trial.

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TACT: The 2013 Trial

The Trial to Assess Chelation Therapy (TACT) enrolled 1,708 people aged 50 or older who had had a heart attack at least 6 weeks earlier (a median of 4.6 years earlier) and whose kidney function was adequate. They were recruited at 134 sites in the United States and Canada between 2003 and 2010 and followed for a median of 55 months. Patients and staff did not know who received real drips. The median age was 65, 18% were women and 31% had diabetes in the main report.

The main result. The combined endpoint was death, another heart attack, stroke, a coronary artery procedure (stent or bypass) or a hospital stay for angina. It occurred in 222 people (26%) in the chelation group and 261 (30%) in the placebo group, a hazard ratio of 0.82 (95% confidence interval 0.69 to 0.99), or about 18% fewer events. Because the trial had looked at its data several times along the way, the result had to reach P = 0.036 to count as significant; it came in at P = 0.035.

The parts, one by one.

• Deaths: 87 (10%) on chelation and 93 (11%) on placebo, no significant difference (hazard ratio 0.93); the trial was not designed to detect a difference in deaths.
• Heart attacks: 6% vs 8% (hazard ratio 0.77, not significant on its own).
• Strokes: 1.2% vs 1.5%.
• Coronary procedures: 15% vs 18% (hazard ratio 0.81).
• Hospital stays for angina: 1.6% vs 2.1%.

Quality of life. In a randomly chosen subset of 911 patients, the Duke Activity Status Index and a mental-health score were measured over 2 years. Activity scores improved in both groups during the first 6 months, with no difference between real and placebo drips, and none of the quality-of-life measures showed a consistent treatment effect.

The investigators' own conclusion was that the drips "modestly reduced the risk of adverse cardiovascular outcomes, many of which were revascularization procedures", and that the results "provide evidence to guide further research but are not sufficient to support the routine use of chelation therapy" after a heart attack.

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The Diabetes Subgroup and the Vitamin Arm

People with diabetes

Diabetes was a pre-planned subgroup. In a 2014 analysis that counted 633 participants with diabetes (37% of the trial), the combined endpoint occurred in 25% of the chelation group and 38% of the placebo group over 5 years (hazard ratio 0.59), and the result stayed significant after correction for the number of subgroups examined. Deaths were 10% vs 16% (hazard ratio 0.57), but this and the secondary endpoint lost statistical significance after that correction. The investigators calculated that 6.5 people with diabetes would need treatment for 5 years to prevent one event. Among the 1,075 people without diabetes there was no reduction in events at all. The authors wrote that the findings supported efforts to replicate them but did "not constitute sufficient evidence" for routine use in people with diabetes after a heart attack. This contrast is what led to TACT2.

The vitamins on their own

The oral high-dose vitamin and mineral mixture, compared with placebo, did not significantly reduce events: 27% vs 30% (hazard ratio 0.89, P = 0.21). About 46% of each group stopped taking the caplets, which the authors said limited firm conclusions. No evidence of harm from the vitamins was found.

The four groups compared

A further 2014 report compared all four combinations. Five-year event estimates were 31.9% with real drips plus real vitamins, 33.7% with real drips plus placebo vitamins, 36.6% with placebo drips plus real vitamins and 40.2% with both placebos. Real drips plus real vitamins versus both placebos gave a hazard ratio of 0.74; among people with diabetes it was 0.49.

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How the TACT Result Was Received

The trial drew published criticism both before and after its results. The points raised in the published record include these:

• Drop-outs. The TACT report states that 289 patients (17%) withdrew consent during the trial, 115 in the chelation group and 174 in the placebo group. The investigators reported that sensitivity analyses for dropout and adherence did not change the result.
• A narrow margin. The main result (P = 0.035) cleared the required threshold (P = 0.036) by a very small amount, and no single component, including deaths, was significant on its own. Many of the prevented events were coronary procedures rather than deaths or heart attacks, as the investigators themselves noted.
• Editorial concerns. JAMA published the trial alongside an editorial titled "Concerns about reliability in the Trial to Assess Chelation Therapy (TACT)". Nature ran a 2012 news report titled "Chelation-therapy heart trial draws fire".
• Design objections before the results. The 2008 critique mentioned in the history section argued, among other points, that the trial's documents conflated edetate disodium with a different, somewhat safer drug (the calcium form), that it lacked precautions needed to minimise risks, and that its outcome would be unreliable and almost certainly equivocal.
• Review-level concerns. The 2020 Cochrane review raised concerns about one included study's risk of bias in blinding and outcome assessment, and rated the overall certainty of the evidence low to very low.

The investigators' response was to run a second trial built to answer the main open question: whether the diabetes benefit was real.

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TACT2: The Repeat Trial in Diabetes

TACT2 was designed to replicate TACT in the group where the effect had looked largest. It enrolled 1,000 people aged 50 or older with diabetes and a heart attack at least 6 weeks earlier, at 88 sites in the United States and Canada between 2016 and 2020. The 959 who received at least one infusion formed the main analysis: 483 on chelation and 476 on placebo. The median age was 67 and 27% were women. Most were already on modern heart medicines: 86.5% took statins and 90.2% took a blood thinner or antiplatelet drug. The trial had more than 85% power to detect a 30% drop in events.

The result. The same combined endpoint occurred in 172 people (35.6%) on chelation and 170 (35.7%) on placebo (adjusted hazard ratio 0.93, 95% confidence interval 0.76 to 1.16; P = 0.53). The 5-year rates were 45.8% and 46.5%. Cardiovascular death, heart attack or stroke occurred in 18.4% and 19.7%. Deaths from any cause were 84 in each group (17.4% and 17.6%). The authors concluded that "despite effectively reducing blood lead levels, EDTA chelation was not effective in reducing cardiovascular events" in this group.

Lead fell, events did not. TACT2 included a trace-metals core laboratory to test whether any benefit came from removing lead and cadmium; the metals were measured at the Centers for Disease Control and Prevention. At the start, blood lead was detectable in every participant (median 9.19 µg/L) and cadmium in 97%, at levels largely similar to the general U.S. population of the same profile. Chelation reduced median blood lead from 9.03 µg/L before treatment to 3.46 µg/L at the 40th infusion; in the placebo group it went from 9.3 to 8.7 µg/L. (These are micrograms per litre; 9 µg/L is 0.9 µg/dL, the unit used on most blood-lead reports.)

The vitamins in TACT2. The oral high-dose vitamin and mineral arm was also null: events occurred in 35% of each group (hazard ratio 0.99). Real drips plus real vitamins compared with both placebos gave a hazard ratio of 0.91, not significant. The report noted a numerically higher, though not significant, rate of heart attack, stroke and cardiovascular death in the active vitamin group.

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What the Pooled Reviews Found

Cochrane, 2020 (before TACT2). Five placebo-controlled trials with 1,993 participants were included, three in leg-artery disease and two in coronary disease. In the two coronary trials there was no evidence of a difference in all-cause deaths (risk ratio 0.97), heart attacks (0.81), angina (0.95) or coronary procedures (0.46, with a very wide range). Walking distances and the ankle-brachial index showed no difference in the leg-artery trials that could be pooled. The review found no evidence of major or minor adverse events and concluded that there was "insufficient evidence to determine the effectiveness or ineffectiveness" of chelation for atherosclerotic disease.

A 2022 systematic review by researchers including TACT investigators cast a wider net: 24 studies, of which only 4 were randomised trials; 15 were before-and-after studies and 5 were case series. Seventeen studies, one of them a randomised trial, reported improvement after treatment; 5 found no significant effect and 2 no qualitative benefit. The largest improvements were in studies with many participants with diabetes or severe arterial blockage, and four studies pooled showed an ankle-brachial index rise of 0.08 from baseline. The authors noted that differences in dose, solution and number of infusions limit comparisons. This review also predates TACT2.

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Safety Findings

Inside the trials. In TACT, about the same share of each group stopped their infusions because of adverse events (16% on chelation, 15% on placebo, as the abstract reports). The TACT investigators' 2014 review states that edetate disodium "proved to be safe" in the trial, which gave weekly infusions and admitted only people with adequate kidney function. The Cochrane review found no evidence of major or minor adverse events across the included trials. In PATCH, one chelation patient had treatment stopped for a temporary rise in creatinine, a marker of kidney function.

Deaths from low blood calcium. In 2006 the Centers for Disease Control and Prevention reported three deaths between 2003 and 2005 from cardiac arrest caused by dangerously low blood calcium (hypocalcemia) during chelation. According to the full report:

• A 2-year-old girl in Texas was being treated in hospital for lead poisoning. Edetate calcium disodium had been ordered; the hospital's review found that a dose of intravenous edetate disodium was given unintentionally instead.
• A 5-year-old boy in Pennsylvania died while receiving intravenous edetate disodium for autism in a physician's office.
• A 53-year-old woman in Oregon died after intravenous EDTA given to remove heavy metals; at the time of the report it was still under investigation which of the two forms she had received.

A companion paper by the same public-health team stated that no earlier deaths from hypocalcemia during chelation had been reported. The agency's report advised hospital pharmacies to review whether stocking edetate disodium was necessary, given its established risk of hypocalcemia and the availability of less toxic alternatives, and noted an ongoing Food and Drug Administration safety review. The same report stated that off-label uses of chelation, including for coronary artery disease, "are not supported by accepted scientific evidence".

The Food and Drug Administration on unapproved products. The agency's question-and-answer page on unapproved chelation products (content current as of 2 February 2016) states that all FDA-approved chelation products require a prescription and that the agency "has never approved any chelation product for OTC use for any health condition". It states that chelation "can result in serious side effects such as dehydration, kidney failure, and death"; that unapproved over-the-counter products, some sold as dietary supplements, have been marketed for autism and heart conditions; and that home test kits promoted by some of these sellers are not cleared by the agency and may give false or misleading results. The site's Provoked Urine Testing page covers the related question of "challenge" urine tests.

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What Practitioners and Patients Report

Chelation practitioners and their patients have described benefits for decades, and these reports are part of why the practice continued and why the trials were funded. They are recorded here as reports.

• The TACT investigators' 2014 review describes complementary and alternative medicine practitioners as having "reported good anecdotal results" with chelation for atherosclerosis.
• The 2008 critique of TACT records practitioners' claim that chelation "dramatically improves symptoms and prolongs life in 80% to 90% of patients".
• The 2022 systematic review found 15 before-and-after studies and 5 case series of repeated EDTA treatment in people with cardiovascular disease, most of which reported improvement in their measured outcomes, with the largest reported improvements in people with diabetes or severe leg-artery blockage.
• Clarke's original 1950s observation, as the site's history article describes it, was of treated patients reporting less angina.

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What Is Not Known

• Why TACT and TACT2 differ. The diabetes benefit in TACT was not seen in TACT2. Published abstracts do not settle whether the first result was chance, or whether something about the later patients (more modern medicines, lower metal levels) explains it.
• Whether metal removal matters for the heart. TACT2 showed that the drips lower blood lead sharply, yet events did not change. Whether a lasting drop in lead or cadmium, in people with higher exposure than the TACT2 participants, would change heart outcomes has not been tested in a trial.
• Which part of the drip does what. The trial solution contained edetate disodium, vitamin C, B vitamins, electrolytes, procaine and heparin. The trials tested the whole mixture against placebo, not its parts.
• Other regimens and other groups. The 2022 systematic review notes that published regimens differ in dose, solution components and number of infusions. The large trials tested one intravenous regimen in people who had already had a heart attack; people who have never had one, and other regimens, were not studied in large trials.
• Long-term effects. Follow-up in both trials was about four to five years.

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Key Research Papers

1. Clarke CN, Clarke NE, Mosher RE. Treatment of angina pectoris with disodium ethylene diamine tetraacetic acid. Am J Med Sci. 1956;232(6):654-66. PubMed PMID: 13372537
2. Lamas GA, Goertz C, Boineau R, Mark DB, Rozema T, Nahin RL, et al.; TACT Investigators. Effect of disodium EDTA chelation regimen on cardiovascular events in patients with previous myocardial infarction: the TACT randomized trial. JAMA. 2013;309(12):1241-50. PubMed PMID: 23532240
3. Lamas GA, Anstrom KJ, Navas-Acien A, Boineau R, Nemeth H, Huang Z, et al.; TACT2 Investigators. Edetate Disodium-Based Chelation for Patients With a Previous Myocardial Infarction and Diabetes: TACT2 Randomized Clinical Trial. JAMA. 2024;332(10):794-803. PubMed PMID: 39141382
4. Lamas GA, Bhatnagar A, Jones MR, Mann KK, Nasir K, Tellez-Plaza M, et al. Contaminant Metals as Cardiovascular Risk Factors: A Scientific Statement From the American Heart Association. J Am Heart Assoc. 2023;12(13):e029852. PubMed PMID: 37306302
5. Escolar E, Lamas GA, Mark DB, Boineau R, Goertz C, Rosenberg Y, et al. The effect of an EDTA-based chelation regimen on patients with diabetes mellitus and prior myocardial infarction in the Trial to Assess Chelation Therapy (TACT). Circ Cardiovasc Qual Outcomes. 2014;7(1):15-24. PubMed PMID: 24254885
6. Mark DB, Anstrom KJ, Clapp-Channing NE, Knight JD, Boineau R, Goertz C, et al. Quality-of-life outcomes with a disodium EDTA chelation regimen for coronary disease: results from the trial to assess chelation therapy randomized trial. Circ Cardiovasc Qual Outcomes. 2014;7(4):508-16. PubMed PMID: 24987051
7. Lamas GA, Boineau R, Goertz C, Mark DB, Rosenberg Y, Stylianou M, et al. Oral high-dose multivitamins and minerals after myocardial infarction: a randomized trial. Ann Intern Med. 2013;159(12):797-805. PubMed PMID: 24490264
8. Lamas GA, Boineau R, Goertz C, Mark DB, Rosenberg Y, Stylianou M, et al. EDTA chelation therapy alone and in combination with oral high-dose multivitamins and minerals for coronary disease: The factorial group results of the Trial to Assess Chelation Therapy. Am Heart J. 2014;168(1):37-44.e5. PubMed PMID: 24952858
9. Lamas GA, Goertz C, Boineau R, Mark DB, Rozema T, Nahin RL, et al. Design of the Trial to Assess Chelation Therapy (TACT). Am Heart J. 2012;163(1):7-12. PubMed PMID: 22172430
10. Lamas GA, Anstrom KJ, Navas-Acien A, Boineau R, Kim H, Rosenberg Y, et al. The trial to assess chelation therapy 2 (TACT2): Rationale and design. Am Heart J. 2022;252:1-11. PubMed PMID: 35598636
11. Navas-Acien A, Santella RM, Joubert BR, Huang Z, Lokhnygina Y, Ujueta F, et al. Baseline characteristics including blood and urine metal levels in the Trial to Assess Chelation Therapy 2 (TACT2). Am Heart J. 2024;273:72-82. PubMed PMID: 38621575
12. Ujueta F, Lamas GA, Anstrom KJ, Navas-Acien A, Boineau R, Rosenberg Y, et al. Multivitamins After Myocardial Infarction in Patients With Diabetes: A Randomized Clinical Trial. JAMA Intern Med. 2025;185(5):540-548. PubMed PMID: 40029647
13. Knudtson ML, Wyse DG, Galbraith PD, Brant R, Hildebrand K, Paterson D, et al. Chelation therapy for ischemic heart disease: a randomized controlled trial. JAMA. 2002;287(4):481-6. PubMed PMID: 11798370
14. Anderson TJ, Hubacek J, Wyse DG, Knudtson ML. Effect of chelation therapy on endothelial function in patients with coronary artery disease: PATCH substudy. J Am Coll Cardiol. 2003;41(3):420-5. PubMed PMID: 12575969
15. Guldager B, Jelnes R, Jørgensen SJ, Nielsen JS, Klaerke A, Mogensen K, et al. EDTA treatment of intermittent claudication--a double-blind, placebo-controlled study. J Intern Med. 1992;231(3):261-7. PubMed PMID: 1556523
16. Sloth-Nielsen J, Guldager B, Mouritzen C, Lund EB, Egeblad M, Nørregaard O, et al. Arteriographic findings in EDTA chelation therapy on peripheral arteriosclerosis. Am J Surg. 1991;162(2):122-5. PubMed PMID: 1907432
17. Guldager B, Faergeman O, Jørgensen SJ, Nexø E, Jelnes R. Disodium-ethylene diamine tetraacetic acid (EDTA) has no effect on blood lipids in atherosclerotic patients. A randomized, placebo-controlled study. Dan Med Bull. 1993;40(5):625-7. PubMed PMID: 8299405
18. Nissen SE. Concerns about reliability in the Trial to Assess Chelation Therapy (TACT). JAMA. 2013;309(12):1293-4. PubMed PMID: 23532246
19. Callaway E. Chelation-therapy heart trial draws fire. Nature. 2012;491(7424):313-5. PubMed PMID: 23151555
20. Atwood KC, Woeckner E, Baratz RS, Sampson WI. Why the NIH Trial to Assess Chelation Therapy (TACT) should be abandoned. Medscape J Med. 2008;10(5):115. PubMed PMID: 18596934
21. Peguero JG, Arenas I, Lamas GA. Chelation therapy and cardiovascular disease: connecting scientific silos to benefit cardiac patients. Trends Cardiovasc Med. 2014;24(6):232-40. PubMed PMID: 25106084
22. Villarruz-Sulit MV, Forster R, Dans AL, Tan FN, Sulit DV. Chelation therapy for atherosclerotic cardiovascular disease. Cochrane Database Syst Rev. 2020;5(5):CD002785. PubMed PMID: 32367513
23. Ravalli F, Vela Parada X, Ujueta F, Pinotti R, Anstrom KJ, Lamas GA, et al. Chelation Therapy in Patients With Cardiovascular Disease: A Systematic Review. J Am Heart Assoc. 2022;11(6):e024648. PubMed PMID: 35229619
24. Centers for Disease Control and Prevention (CDC). Deaths associated with hypocalcemia from chelation therapy--Texas, Pennsylvania, and Oregon, 2003-2005. MMWR Morb Mortal Wkly Rep. 2006;55(8):204-7. PubMed PMID: 16511441
25. Brown MJ, Willis T, Omalu B, Leiker R. Deaths resulting from hypocalcemia after administration of edetate disodium: 2003-2005. Pediatrics. 2006;118(2):e534-6. PubMed PMID: 16882789
26. Lanphear BP, Rauch S, Auinger P, Allen RW, Hornung RW. Low-level lead exposure and mortality in US adults: a population-based cohort study. Lancet Public Health. 2018;3(4):e177-e184. PubMed PMID: 29544878
27. Larsson SC, Wolk A. Urinary cadmium and mortality from all causes, cancer and cardiovascular disease in the general population: systematic review and meta-analysis of cohort studies. Int J Epidemiol. 2016;45(3):782-91. PubMed PMID: 25997435

Government pages: Centers for Disease Control and Prevention, MMWR full report, 3 March 2006; U.S. Food and Drug Administration, Questions and Answers on Unapproved Chelation Products.

PubMed Topic Searches

1. PubMed: edetate disodium chelation and cardiovascular events
2. PubMed: Trial to Assess Chelation Therapy (TACT and TACT2)
3. PubMed: lead, cadmium and cardiovascular disease
4. PubMed: chelation and hypocalcemia deaths

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Connections

• Gut, Liver and Detox — the parent hub
• Natural Detox Protocols: History and Origins — where Clarke's observation fits in the wider detox story
• Natural Detox Protocols — the detox topic page
• Heavy Metals Panel — how lead, cadmium and other metals are measured
• Lead Poisoning — sources, health effects and hospital chelation
• Cadmium Toxicity — the other metal TACT2 measured
• Heavy Metals in Food — everyday exposure to lead, mercury, arsenic and cadmium
• Provoked Urine Testing — the "challenge" urine tests used in chelation practice
• Atherosclerosis — the artery disease chelation was offered for
• Angina — the chest pain Clarke's patients reported less of
• Heart Attack — the condition every TACT participant had had
• Type 2 Diabetes — the group TACT2 studied

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