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The effect of EDTA-based chelation on patients with diabetes and peripheral artery disease in the Trial to Assess Chelation Therapy (TACT).

Publication ,  Journal Article
Ujueta, F; Arenas, IA; Escolar, E; Diaz, D; Boineau, R; Mark, DB; Golden, P; Lindblad, L; Kim, H; Lee, KL; Lamas, GA
Published in: J Diabetes Complications
July 2019

OBJECTIVE: Approximately 1 in 7 US adults have diabetes; and over 60% of deaths in patients with diabetes have cardiac disease as a principal or contributing cause. Both coronary and peripheral artery disease (PAD) identify high-risk cohorts among patients with diabetes. We have previously demonstrated improved cardiovascular outcomes with edetate disodium-based chelation in post-MI patients with diabetes, enrolled in the Trial to Assess Chelation Therapy (TACT). In these analyses we further studied the effect size of patients with diabetes and severe disease in 2 vascular beds; coronaries, and lower extremity arteries. We questioned whether greater atherosclerotic burden would attenuate the observed beneficial effect of edetate disodium infusions. RESEARCH DESIGN AND METHODS: The multicenter TACT used a double blind, placebo controlled, 2 × 2 factorial design with 1708 participants, randomly assigned to receive edetate disodium-based chelation, or placebo and high dose oral vitamins or placebo. There were 162 (9.5% of 1708) post-MI patients with a diagnosis of diabetes mellitus and PAD for this post hoc analysis. Patients received up to 40 double-blind intravenous infusions of edetate disodium-based chelation, or placebo. The composite primary endpoint of TACT consisted of death from any cause, myocardial infarction, stroke, coronary revascularization and hospitalization for angina. RESULTS: The median age was 66 years, 15% female, 5% non-Caucasian, and BMI was 31. Insulin was used by 32% of patients. Active infusions significantly reduced the primary endpoint compared with placebo infusions (HR, 0.52; 95% CI, 0.30-0.92; P = 0.0069), with a 30% absolute risk reduction in the primary endpoint. There was a marked reduction in total mortality from 24% to 11%, although of borderline significance (P = 0.052). CONCLUSION: Atherosclerotic disease in multiple vascular beds did not attenuate the beneficial effect of edetate disodium infusions in post MI patients with diabetes. Studies now in progress will prospectively test this post hoc finding.

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Published In

J Diabetes Complications

DOI

EISSN

1873-460X

Publication Date

July 2019

Volume

33

Issue

7

Start / End Page

490 / 494

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Placebos
  • Peripheral Arterial Disease
  • Myocardial Infarction
  • Mortality
  • Middle Aged
  • Male
  • Incidence
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Ujueta, F., Arenas, I. A., Escolar, E., Diaz, D., Boineau, R., Mark, D. B., … Lamas, G. A. (2019). The effect of EDTA-based chelation on patients with diabetes and peripheral artery disease in the Trial to Assess Chelation Therapy (TACT). J Diabetes Complications, 33(7), 490–494. https://doi.org/10.1016/j.jdiacomp.2019.04.005
Ujueta, Francisco, Ivan A. Arenas, Esteban Escolar, Denisse Diaz, Robin Boineau, Daniel B. Mark, Patrick Golden, et al. “The effect of EDTA-based chelation on patients with diabetes and peripheral artery disease in the Trial to Assess Chelation Therapy (TACT).J Diabetes Complications 33, no. 7 (July 2019): 490–94. https://doi.org/10.1016/j.jdiacomp.2019.04.005.
Ujueta F, Arenas IA, Escolar E, Diaz D, Boineau R, Mark DB, et al. The effect of EDTA-based chelation on patients with diabetes and peripheral artery disease in the Trial to Assess Chelation Therapy (TACT). J Diabetes Complications. 2019 Jul;33(7):490–4.
Ujueta, Francisco, et al. “The effect of EDTA-based chelation on patients with diabetes and peripheral artery disease in the Trial to Assess Chelation Therapy (TACT).J Diabetes Complications, vol. 33, no. 7, July 2019, pp. 490–94. Pubmed, doi:10.1016/j.jdiacomp.2019.04.005.
Ujueta F, Arenas IA, Escolar E, Diaz D, Boineau R, Mark DB, Golden P, Lindblad L, Kim H, Lee KL, Lamas GA. The effect of EDTA-based chelation on patients with diabetes and peripheral artery disease in the Trial to Assess Chelation Therapy (TACT). J Diabetes Complications. 2019 Jul;33(7):490–494.
Journal cover image

Published In

J Diabetes Complications

DOI

EISSN

1873-460X

Publication Date

July 2019

Volume

33

Issue

7

Start / End Page

490 / 494

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Placebos
  • Peripheral Arterial Disease
  • Myocardial Infarction
  • Mortality
  • Middle Aged
  • Male
  • Incidence
  • Humans
  • Female