CardioSource WorldNews December 2014 - Page 55

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 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