Edetate Disodium–Based Chelation for Patients With a Previous Myocardial Infarction and Diabetes

作者：Gervasio A. Lamas, Kevin J. Anstrom, Ana Navas‐Acién, Robin Boineau, Hayley Nemeth, Zhen Huang, Jun Wen, Yves Rosenberg, Mario Stylianou, Teresa L.Z. Jones, Bonnie R. Joubert, Qilu Yu, Regina M. Santella, Ana C. Mon, Francisco Ujueta, Esteban Escolar, David M. Nathan, Vivian Fonseca, Y. Wady Aude, Jonathan K. Ehrman, T.S.J. Elliott, Rakesh Prashad, Eldrin F. Lewis, Renato D. Lopes, Michael E. Farkouh, Anne-Marie Elliott, Jonathan Newman, Daniel B. Mark, TACT2 Investigators, Philip Bear, Donna Prouty, Jodi Baxter, Jonathan K. Ehrman, Heather Golden, Vikrant Katoch, Raffi K. Krikorian, André Paixão, Fujiko Anazawa, Leybi Ramirez-Kelly, Abby Nolen, Venus Barney, Gerald Natzke, Rodica Pop‐Busui, Cindy Plunkett, Laura Meyer, J. Kirk Roberts, Scott A. Rollins, Tamra Hollis, Nampalli Vijay, Melinda Washam, David Zidar, Terence Semenec, Lauren Huntington, Amanda Klumpp, Matthew S. Doughty, Jeffrey Baker, Joseph P. Allen, Rebecca Cortez, Bhaskar Purushottam, Kirstin Stauffacher, Kelly J. Airey, Elena Christofides, Jordyn Conway, David Hoffman, Patty Schuler, Ronald M Solbrig, Loni Chacon, Phillip D. Levy, Linda Gojcevic, R. Eric Collins, John Miles McClure, Ellen Mook, Christopher R. deFilippi, Wendy Sheaffer, Antoinette Bonaccorso, Daniel Donovan, Julee Hartwell, Andrew P. Garner, Dawn Kalbfliesh, David H. Hsi, Maryanne Ducey, Paula Trump, Urs A. Leuenberger, Katie Loffredo, Betty Persico, Allan Magaziner, Dennis Goodman, Michela L. Garabedian, J. Coates, Jeanne P. Wingo, Sheldon H. Gottlieb, Michael Schächter, Sally Minniefield, Olakunle Akinboboye, Kazi Masel Ullah, Karen Wolske, Dennis Friedman, Daniel Lorber, M. Tsovian, Regina Druz, Patricia Hodnett, Stephanie Meller, Maria B. Bartolome, Giselle Cortez Vargas, Ian Ergui, Francisco Ujueta, Priscilla Valls, Marnie Lozada, Raul R. Blanco, Ivan A. Arenas, Esteban Escolar, Xiaoou Pan, Ilana Seidel, Melisa Corado-Williams, Ana Lamas, Mariana Viera-Navarro, Miguel Á. Treviño, Kimberly Mai, Rachel S. Eidelman, Gabriela Reyes, Kelly Brown, Ricardo Yaryura, Amy Little, Heber Varela, Malu Bienes, Robert Jeanfreau, Paul Neff, Mark S. Thompson, Melody Lineberger-Moore, Donna Miller, Rakesh Prashad, John Schmedtje, Melissa M. Shelton, Charles B. Treasure, Ashley Freel, Gerardo Rojas, Damaris Bruceles, Gabriel I. Uwaifo, Veronica Hixon- Calliet, Amber Passini, Stacey Melton, Denise Moreno, Antonio Blanco, Anisia Otero, Mayra Rodriguez, Felix Sogade, Simisola O. Oludare, Vivian Fonseca, Cynthia Moreau, Sofia Marquez, Phillip A. Duncan, Unice Davis, Steven Tang, Bonnie DeMuth, D. Christie, Lorin Roberts, Amanda Martin, Lan Luo, Summer Waddle, Shameka Brown, Salvatore Lo Bianco, Helmut O. Steinberg, Amy Bell, Dharmendra Patel, Alison Bailey, Michelle C. Rice, David Herrington, Karen Blinson, Lynda Doomy, David Smith, Jenny Norton, Suvi Gross, Assad Mouhaffel, Clinton Guillory, Samantha Korn, Y. Wady Aude, Yirsa Esparza, Sonia Leal, Leidy Abreu, Eric Auerbach, Cindy Huff, Miriam Brooks, Marina Johnson, Tammy D. Allen, Arthur J. Berkson, Krystal McAuliffe, Holly Little, Raymond Little, Jalal Abbas, Christina Collard, Jamie Foreman, Shelby Richardson, Andre Desire, Ayham Shneker, Omar Cordero, Piotr Kunik, Radoslav Kiesz, K. Sasser, Patrick Golden, Renee Garden, Allen Green, Gordon Fung, Keith Uyemura, Sajad Hamal, Matthew J. Budoff, Dinh Dinh, Jenny Nguyen, Ashwini Erande, Kelly Brink, Shaista Malik, Nicolas Chronos, Nicole Maslanka, Philip O'Donnell, Margaret Ann Bittorf, Rajesh Garg, Della Matheson, Aldo Martinez, Yasiel Hernandez, Walter Herbert Haught, Lisa Eskridge, Naseem Jaffrani, Melissa Trimble, James Powell, Winifred Bryant, Nakeydia Bryant, Shmuel Bergman, Rezelle Libuit, Angelica Bringas, Diana Visentin, Lori Murphy, Adrienne Junek, Shadi Nahas, Joseph Berlingieri, Caroline Urso, Alireza Moshiri, T.S.J. Elliott, Marla Inducil, Wanda Parker, Ryan Stults, Hwasoon Kim, Beatriz Acevedo · 发表于：JAMA · 年份：2024 · DOI：10.1001/jama.2024.11463 · 被引用次数：26 · 研究领域：Cardiac electrophysiology and arrhythmias、Folate and B Vitamins Research、Trace Elements in Health

Importance: In 2013, the Trial to Assess Chelation Therapy (TACT) reported that edetate disodium (EDTA)-based chelation significantly reduced cardiovascular disease (CVD) events by 18% in 1708 patients with a prior myocardial infarction (MI). Objective: To replicate the finding of TACT in individuals with diabetes and previous MI. Design, Setting, and Participants: A 2 × 2 factorial, double-masked, placebo-controlled, multicenter trial at 88 sites in the US and Canada, involving participants who were 50 years or older, had diabetes, and had experienced an MI at least 6 weeks before recruitment compared the effect of EDTA-based chelation vs placebo infusions on CVD events and compared the effect of high doses of oral multivitamins and minerals with oral placebo. This article reports on the chelation vs placebo infusion comparisons. Interventions: Eligible participants were randomly assigned to 40 weekly infusions of an EDTA-based chelation solution or matching placebo and to twice daily oral, high-dose multivitamin and mineral supplements or matching placebo for 60 months. This article addresses the chelation study. Main Outcomes and Measures: The primary end point was the composite of all-cause mortality, MI, stroke, coronary revascularization, or hospitalization for unstable angina. Median follow-up was 48 months. Primary comparisons were made from patients who received at least 1 assigned infusion. Results: Of the 959 participants (median age, 67 years [IQR, 60-72 years]; 2...