Therapy for Coronary Artery Disease
- What is coronary artery disease?
- How is CAD diagnosed and treated?
- What is EDTA chelation therapy?
- Does EDTA chelation therapy have side effects?
- How might EDTA chelation therapy work to clear blocked arteries?
- Is there evidence that EDTA chelation therapy works for CAD?
- How frequently is EDTA chelation therapy used?
Coronary artery disease (CAD) is the most common form of heart disease. In CAD the coronary arteries, the vessels that bring oxygen-rich blood to the tissues of the heart, become blocked by deposits of a fatty substance called plaque. As plaque builds, the arteries become narrower and less oxygen and nutrients are transported to the heart. This condition can lead to serious problems, such as angina (pain caused by not enough oxygen-carrying blood reaching the heart) and heart attack. In a heart attack, or myocardial infarction, there is such poor oxygen supply to the heart that part of the heart muscle dies. If a sufficiently large portion of the heart is affected, it may no longer be able to pump blood efficiently to the rest of the body, resulting in death or chronic heart failure.
Approximately 7 million Americans suffer from CAD. It is the leading cause of death among American men and women; more than 500,000 Americans die of CAD-related heart attacks each year.
There are several factors that can each increase the risk of developing CAD:
- High blood pressure
- High cholesterol levels
- Smoking
- Obesity
- Physical inactivity
- Diabetes
- Family history of CAD
- Gender
- Age
A person with CAD may or may not have symptoms. Symptoms can include chest pain from angina, shortness of breath, lightheadedness, cold sweats, or nausea.
Because the severity of CAD and its symptoms can vary from person to person, the way the disease is diagnosed and treated can also vary. CAD is often diagnosed through a series of tests that can include blood tests to see if protein has been released into the bloodstream from damaged heart tissues, electrocardiograms (EKG) to check the heart's electrical activity, "stress" tests to record the heartbeat during exercise, nuclear scanning to check for damaged areas of the heart, and angiography to see how blood flows.
Treatment of CAD depends on many factors, such as the patient's age, heart function, and overall health. Often, treatment begins with focusing on lifestyle--stopping smoking for patients who smoke, reducing fat in the diet, and engaging in a prescribed exercise program. Medications may also be prescribed, such as aspirin to prevent additional heart attacks, medications that decrease the workload on the heart, or medicines to reduce high blood cholesterol levels or high blood pressure. If these efforts are not effective, a patient may need to have the narrowed or blocked arteries re-opened through a procedure called balloon angioplasty, or bypassed through surgery. Balloon angioplasty involves threading a thin tube into the artery and expanding a balloon-like apparatus as a way to increase the size of the artery so more blood can flow. Bypass surgery is used to treat severe blockages by using veins or arteries from other areas of the body to divert blood flow around the blocked coronary arteries.
Chelation is a chemical process in which a substance is used to bind molecules, such as metals or minerals, and hold them tightly so that they can be removed from a system, such as the body. In medicine, chelation has been scientifically proven to rid the body of excess or toxic metals. For example, a person who has lead poisoning may be given chelation therapy in order to bind and remove excess lead from the body before it can cause damage.
In the case of EDTA chelation therapy, the substance that binds and removes metals and minerals is EDTA (ethylene diamine tetra-acetic acid), a synthetic, or man-made, amino acid that is delivered intravenously (through the veins). EDTA was first used in the 1940s for the treatment of heavy metal poisoning. EDTA chelation removes heavy metals and minerals from the blood, such as lead, iron, copper, and calcium, and is approved by the U.S. Food and Drug Administration (FDA) for use in treating lead poisoning and toxicity from other heavy metals. Although it is not approved by the FDA to treat CAD, some physicians and alternative medicine practitioners have recommended EDTA chelation as a way to treat this disorder.
When used as approved by the FDA (at the appropriate dose and infusion rate) for treatment of heavy metal poisoning, chelation with EDTA has a low occurrence of side effects. The most common side effect is a burning sensation experienced at the site where the EDTA is delivered into the veins. Rare side effects can include fever, hypotension (a sudden drop in blood pressure), hypocalcemia (abnormally low calcium levels in the blood), headache, nausea, vomiting, and bone marrow depression (meaning that blood cell counts fall). Injury to the kidneys has been reported with EDTA chelation therapy, but it is rare. Other serious side effects can occur if EDTA is not administered by a trained health professional.
5. How might EDTA chelation therapy work to clear blocked arteries?
Several theories have been suggested by those who recommend this form of treatment. One theory suggests that EDTA chelation might work by directly removing calcium found in fatty plaques that block the arteries, causing the plaques to break up. Another is that the process of chelation may stimulate the release of a hormone that in turn causes calcium to be removed from the plaques or causes a lowering of cholesterol levels. A third theory is that EDTA chelation therapy may work by reducing the damaging effects of oxygen ions (oxidative stress) on the walls of the blood vessels. Reducing oxidative stress could reduce inflammation in the arteries and improve blood vessel function. None of these theories has been well tested in scientific studies.
There is a lack of adequate prior research to verify EDTA chelation therapy's safety and effectiveness for CAD. The bulk of the evidence supporting the use of EDTA chelation therapy is in the form of case reports and case series. Some patients who have undergone chelation therapy and the physicians who prescribed it claim improvement in CAD. In addition, there are approximately 12 published descriptive studies and 5 randomized controlled clinical trials regarding the use of EDTA chelation for CAD. Although each descriptive study did report a reduction in angina, they were uncontrolled clinical observations or retrospective data, typically with a small number of participants. Of the five clinical trials in which patients were randomly selected to receive chelation therapy or a placebo (a dummy solution), the most rigorous way of assessing a new treatment, three trials involved so few people that only a dramatic improvement could have been detected. Studies need a larger number of participants to detect more mild benefits of a treatment. The fourth study was never published in final form, so its conclusions are uncertain. Finally, the fifth study reported that EDTA chelation was associated with an improvement in ability to exercise, but it had only 10 participants.
It is estimated by the American College for Advancement in Medicine, a professional association that supports the use of chelation therapy, that more than 800,000 visits for chelation therapy were made in the United States in 1997 alone.
CAD is the leading cause of death among men and women in the United States. In spite of effective standard therapies, such as lifestyle modifications, medications, and surgical procedures, patients with CAD are continuously seeking out EDTA chelation therapy as a treatment alternative or option.
