title: Should EDTA chelation therapy be used instead of long-term clopidogrel plus aspirin to treat patients at risk from drug-eluting stents?
abstract: The recently discovered increased risk of blood clots, leading to myocardial infarction and sudden death beginning six months after medicated stents are implanted in patients following percutaneous transluminal coronary angioplasty (PTCA), has left cardiologists pondering what course of action to take. The purpose of adding implanted medication to a stent is to prevent thrombin accumulation and restenosis. However, these stents may increase, rather than decrease, the risk. Although long-term treatment with clopidogrel bisulfate (Plavix) plus aspirin for at least 12 months has been suggested as a preventive treatment, there is no evidence from randomized, controlled trials that this treatment is effective for more than six months. Clopidogrel also increases the risk of major bleeding episodes. The author served as the primary investigator for a study that showed cardiovascular patients treated with EDTA chelation therapy had a lower rate of subsequent cardiac events, including myocardial infarction and death, than those treated with cardiac medications, PTCA, or coronary artery bypass graft (CABG). The data also indicated chelation therapy might be effective in preventing thrombosis and cardiac events from stent implantation. There is evidence EDTA chelation therapy might prevent hypercoagulability resulting from the placement of stents, although not specifically medicated stents. Based on the limited data currently available, intravenous EDTA may be safe and effective for treating patients who have implanted medicated stents. Prospective clinical trials are needed, and EDTA should be included in those trials.
authors.forename: L Terry
authors.initials: LT
authors.lastname: Chappell
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D001241:Aspirin / Q000627:therapeutic use; D002614:Chelating Agents / Q000627:therapeutic use*; D000077144:Clopidogrel; D004343:Drug Implants / Q000009:adverse effects*; D004492:Edetic Acid / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000139:chemically induced / Q000517:prevention & control*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D015607:Stents / Q000009:adverse effects*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D002614:Chelating Agents; D004343:Drug Implants; D010975:Platelet Aggregation Inhibitors; D004492:Edetic Acid; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin