Patients with diabetes — but not their nondiabetic counterparts — had lower event rates following chelation therapy. Also, antidotes for the new oral anticoagulants may be on the way.

Chelation Has Benefits in Patients With Diabetes

Chelation reduced major cardiovascular events in patients with diabetes, but not in those without diabetes, a subgroup analysis of the TACT trial showed.

The overall trial results, reported at the American Heart Association meeting last year, showed a significant benefit from chelation therapy using disodium ethylene diamine tetra-acetic acid (EDTA) versus placebo in patients 50 and older who had had a prior myocardial infarction.

But the new analysis — which was presented at this year’s AHA meeting and published in Circulation: Cardiovascular Quality and Outcomes — suggests that the benefit is confined to the patients with diabetes, who made up 37% of the trial population. In that subgroup, the risk of any cardiovascular event — including death, reinfarction, stroke, coronary revascularization, or hospitalization for angina — over 5 years was reduced by 41% with chelation (25% versus 38%; HR 0.59, 95% CI 0.44-0.79). The number needed to treat was 6.5.

‘These findings support efforts to replicate these findings and define the mechanisms of benefit,’ Gervasio Lamas, MD, of Mount […]