Diabetes and Heart attacks: Too much TACT or not enough?
How chelation therapy could save your or your parent’s life
Alternative medicine minded doctors have been using chelation therapy for cardiovascular disease for 50 years. Recognizing that great numbers of people who received this therapy without a big study to back it up, the National Center for Complementary Medicine (NCCAM ) and the National Heart Lung and Blood Institute (NHLBI), in April 2001, released a
$30 million study called the Trial to Assess Chelation Therapy1 (TACT). It was designed to see the effects of 40 chelations along with oral vitamins in people who’d already had a heart attack at least 6 month before the study and were over 50 years old. They decided to look at the overall outcome and specifically those with diabetes. Nobody was supposed to know what treatment group they were in. The groups were:
IV Chelation + ORAL high dose vitamins
IV Placebo chelation + ORAL high-dose vitamins
IV Chelation + ORAL Placebo Vitamins
IV Placebo chelation + ORAL placebo vitamins
Originally, they wanted 2372 patients, feeling that that was the number needed to tell a 25% difference, but this was not an easy study on patients who were scheduled to receive 40 IV infusion each lasting about 3 hours, the first 30 of which were every week. And in the end they only got 1708 people. The randomized groups were well matched. They were followed up for on average 55 months.
There was an 18% reduction in the primary end points collectively (death, heart attack, stroke coronary revascularization, and hospitalization for angina). That means the Hazard ratio was 0.82.
The reduced risk of the individual end points were:
Heart attack 23%
Getting a revascularization procedure 19%
Getting hospitalized for angina 28%
Every single one was better with chelation.
So why wasn’t this big news?
Well, the way studies are designed you have to have a LOT of people, so that the statisticians can say, “we are 95% sure.” Each of those numbers had another set of numbers called the 95% confidence interval attached to it. The one for getting a coronary revascularization procedure was 0.64-1.02. That means that the real risk reduction for having that happen if you had chelation to be 95% sure was somewhere between 0.72 (as 28% risk reduction) to 1.02 (a 2% increased risk).
Any time the confidence interval includes 1.0 that means there is at least a 5% chance there was no difference.
The category of “all endpoints” didn’t include 1.0, but the individual ones all did so the researches were forced to say “We’re still not sure.” Now recall that this did not take into account the vitamins.
If you split the groups up and actually compare the ones that had both IV Chelation and vitamins compared to the ones who had neither you again have a reduced risk in all events, but now the numbers are even more impressive.
Reduction (95% confidence intervals)
All endpoints combined 26% 0.57-0.95
CV death, MI or stroke 34% 0.44-0.99
Death 13%, 0.57-1.30
Heart attack 29% 0.42-1.21
Stroke 44% 0.13-1.42
Getting a revascularization procedure 33% 0.48-0.94
Getting hospitalized for angina 51% 0.18-1.31
But because the numbers were even smaller 421 vs 437 people and these complications
weren’t common, the confidence interval still often included 1.0 in 4 of these 7 categories.
Now if you look at the diabetic patients:
All endpoints combined 41% 0.44-0.75
CV death, MI or stroke 40% 0.39-0.91
Death 43%, 0.36-0.88
Heart attack 37% 0.35-1.13
Stroke -19% 0.27-5.30
Getting a revascularization procedure 32% 0.48-0.99
Getting hospitalized for angina 28% 0.2-2.36
The stroke number may look scary but that was the least likely event of all of those by far with only about 1% of each group having a stroke. Essentially, there was no difference in stroke.
But when you step back that’s a 41% lower risk of the combination of those bad things happening. That’s an enormous difference. The chance of that happening by random chance was 1 in 1000.
Do you know anyone with diabetes who’s had a heart attack? As I write this, its 5 days before Father’s Day and I think back to my own dad. He had a bypass operation 34 years ago; 25 years ago, he got diabetes. About 2 years ago he had a heart attack. He never felt it, but that is how it is with diabetes sometimes. I encouraged him to look into chelation, but I was never very forceful about it. Eight months ago his heart finally gave out and he died. This will be my first Father’s Day without him.
Admittedly, I never realized just how impressive the numbers for diabetics were in the TACT trial until I started studying for further chelation education this week. But I still had a general idea of how good it could be. Perhaps I just had too much tact with him. As a depression era baby he hated to spend money but maybe had I pushed it harder he’d still be here.
Whose life could you save?
Love you, Dad
1. Lamas, Gervasio et al JAMA. Effect of Disodium EDTA Chelation Regimen on Cardiovascular Events in Patients With Previous Myocardial Infarction The TACT Randomized Trial 2013;309 (12):1241-1250