GUEST COMMENTARY
Gervasio A. Lamas, MD
The Road to TACT2
Updates from the Second Trial
to Assess Chelation Therapy
I
n 2013, I wrote, in response to a column by Chris
Cannon, MD, about the difficulties encountered in
changing minds. Chris had written about anticoagulation. I wrote about difficulties encountered
convincing my colleagues to look dispassionately at
a clinical trial about a pariah therapy,
EDTA chelation for coronary disease.
I don’t want to go over all the strange
bumps we encountered on the road to
completion of the 134-site, 55,222-infuGervasio A.
sion study.1 At the end of this year, howLamas, MD
ever, I am proud of our profession. We
TACT investigators discovered that we could always
find an objective and curious editor, or editorialist,
who would look at the data, look at the investigators,
and ask him or herself, “Is this a new paradigm in
treating coronary disease?” NIH co-investigators and
FDA reviewers also proved themselves solid scientists – willing to ask hard questions, but also willing
to listen to the answers, and then act on them. Still
others looked at the study objectively because they
resented the negative attitude of others in the cardiology establishment.
I engaged actively in changing minds as well.
I joined Twitter and LinkedIn. I post comments
that relate to TACT and data interpretation. I am
definitely tiresome, but the message gets across to
professionals and to lay people. I chased lay press
and finally was interviewed by The Atlantic.2 I
have given innumerable lectures and grand rounds.
When the Kaplan Meier curves appear, there is
always a sucking in of breath – you can’t beat a 41%
reduction in MACE-plus in diabetic post MI patients - and there it is – in Technicolor.3,4 At the end,
the questions vary, but the
answers have all been peerScan the code to
read Dr. Lamas’
reviewed and published.
October 2013 comIt is what it is, whether
mentary in CSWN.
we conventional docs like
it or not. Ethylene diamine
tetraacetic acid (EDTA)
chelation therapy, as used in
TACT, is safe and effective
in reducing coronary events
CardioSource.org/CSWN
in post MI patients
TABLE. Summary of TACT Results
over 50 years old with
a creatinine of 2.0 mg/
dl or less. In diabetic
patients, the results are
spectacular. When you
look at the table below,
remember that the
5-year NNT for secondary prevention of death
with statins in diabetes
is 19 (10 to 90). In
TACT (TAB 1