Fodder for quacks: study on chelation for heart disease proves nothing

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Screening teen athletes for heart conditionAlthough chelation has been approved by the Food and Drug Administration to treat heavy metal poisoning such as from lead or mercury a growing number of alternative medicine practitioners have been promoting its off-label use as a means of treating diseases such as autism and heart disease. Now, the controversial practice is causing more concern as the results of a government-funded study clouded by ethical and scientific controversy raised more questions than answers in the efficacy of the therapy in preventing heart disease.

Even though heavy metals are not a known cause of heart problems, occasional reports of chelation aiding patients with chest pains prompted scientists, particularly those practicing alternative medicine, to advocate studying the therapy for heart patients.

Funded by the National Institutes of Health s National Center for Complementary and Alternative Medicine, the 10-year study was designed to address the issue of whether chelation may play a role in heart disease treatment or prevention. Although the researchers found that patients receiving weekly infusions of the treatment were slightly less likely to have adverse heart events, heart experts, including even the study author, remain unconvinced, saying that the treatment cannot be recommended without further research. The results were presented at this year s American Heart Association s Scientific Sessions.

Researchers based at 134 centers in the U.S. and Canada studied 1,700 patients who had suffered a previous heart attack. The study subjects were randomly divided into two groups, one of which received a combination chelation solution while others got a placebo. Four years after treatment, 27 percent of the chelation group were recorded as experiencing either a repeat heart attack, stroke, death, hospitalization for chest pain or need for an artery-opening procedure, as compared with 30 percent among those who received the placebo infusions.

However, one-sixth of the participants dropped out before the study ended, and only two-thirds received all 40 infusions they were supposed to get. The missing and incomplete results make it unclear whether the benefit credited to chelation could have occurred by chance alone.

For people to even use standard practice and chelation in the same sentence is frightening, says ACSH s Dr. Gilbert Ross. Although this is a relatively small study, there is no doubt that this will cause uproar, especially among the quacks who are already treating desperate patients with chelation for a variety of conditions where its use is completely unfounded and quite likely to be harmful. And frankly I am worried that this may cause harm to the public. Doctors should not offer this therapy, nor should patients seek it, on the basis of this trial.

Whatever little effect the study revealed is very likely due to confounding factors uncontrolled variables in the trial, adds ACSH s Dr. Josh Bloom, For instance, included in the chelation solution was a blood thinner already part of the standard regimen for cardiovascular disease. Didn t it occur to anyone that this alone could very well be responsible for whatever small benefit they saw?