The number one cause of death in the USA is heart disease. In fact coronary artery disease (CAD) continues to be the greatest cause of premature death in industrialized countries. The death rates associated with CAD surpass that of breast cancer in females and that of prostate cancer in males. The general treatment for heart disease focuses on preventing further progression of the disease.

Common ideas used in treating coronary artery disease consists of:

• Stop Smoking (stop smoking programs)
• Treatment of High Cholesterol &Ttriglyceride Levels
• Increase HDL (Good Cholesterol)
• Homocysteine Reduction
• CRP Reduction
• Control Of Blood Pressure
• Exercise
• Stress Reduction
• Weight Loss
• Diet Changes
• Prophylactic Aspirin, Vitamin E, C
• Diabetes Mellitus treated early and adequately
• Hormone Replacement Therapy in men & postmenopausal women

For managing more severe cases of coronary artery disease, bypass surgery and angioplasty have been used to restore blood flow to the damaged heart. Chelation therapy, a procedure using intravenous administration of EDTA (ethylene diamine tetra-acetic acid), may offer a safer and more cost-effective means of treating CAD. Thus it is the aim of this paper to educate the general public on this issue with special emphasis towards the general population on the potential alternatives to bypass surgery and coronary angioplasty and to other conventional modalities for the treatment of atherosclerosis (or thickening of the arteries).

Since 1969 bypass surgery has become a viable procedure for coronary artery disease. It appears, however, according to the research that the long-term effectiveness (greater than 5 years) after bypass surgery is less optimistic than could be shown from its short-term life saving benefits. In fact, a well-documented critique indicated that "bypass surgery has not proven effective in many cases in either preventing heart attacks or prolonging life". In fact, the actual procedure of bypass surgery can cause death in about 5% of patients. After surgery, survival can be further complicated by adverse events.

Some of the major dangers that may follow after bypass include:

• Stroke
• Cognitive defects and psychological effects
• Brain damage-afflicting as many as 150,000 persons per year in the US
• Arrhythmia's
• Chest/Leg wound discomfort
• Blood transfusions

In addition, patients should be reminded that bypass is not a long-lasting solution to coronary artery disease. A consensus among cardiologists, not biased toward bypass or angioplasty, agreed that attention to the "secondary prevention" of risk factors (i.e. lifestyle factors after bypass) would have the most influence on the long-term benefits from surgery.

Angioplasty used since 1977 is a less invasive procedure to bypass surgery. Success depends on clearing the blockage while preserving the vessel wall. Angioplasty is judged to have failed if the damaged artery cannot be "opened" without a major complication. The 6 month out-come for angioplasty is limited by the blood vessels closing up again. In fact "re-closing" of the heart artery occurs in 25-55% of cases, and is frequently associated with reduced blood flow to the heart. Often the patient with a re-closure of the heart blood vessel, including other vessels, is referred for bypass. Angioplasty risks are higher in patients with:

• An acute heart attack, heart failure, multi-vessel disease, unstable angina
• Women and older patients

According to 1990 figures, approximately 3.7% of patients having angioplasty require emergency surgery; of these, 39 percent have heart tissue death and 5% die.

The medical care costs for both angioplasty and bypass surgery runs into the tens of thousands of dollars. A study in The New England Journal of Medicine compared costs between angioplasty and bypass surgery over a 5 year period. The average initial cost of angioplasty versus bypass was $21,113 and $32,347 (all in US dollars) with two-vessel disease, but after 5 years the total medical costs was $52,930 vs. $58,498. In patients with three-vessel disease the cost for angioplasty was $60,918 and $59,430 for bypass. It is important to mention that the cost for time off work and increased need for doctor visits, prescription medications, and compensated quality of life need to be considered as well for the overall costs of surgery.

Chelation therapy appears to offer a more cost effective, non-invasive, less traumatic and viable alternative approach to coronary artery disease. In fact, there is no requirement or dependency on costly, potentially fatal surgical revascularization success. Moreover, according to Rozema, chelation therapy benefits all forms of atherosclerosis. Therapy involves intravenous EDTA infusion over 1.5-3.0 hours. The therapy is commonly administered 1-2/week overall encompassing 30 or more infusions (note: frequency and series numbers depend on the extent of heart disease).

Potential dangers to both chelation administration and post-effects are rare and limited to:

• Patients who can not tolerate the chemical EDTA
• Patients with acute lead encephalopathy
• Patients on renal dialysis

It has been estimated that kidney damage from chelation occurs in less than 1 in 30,000 patients, and then only in those with pre-existing kidney problems. More than 400,000 patients have received over 4 million treatments during the past 30 years. Not one death has been directly caused by chelation therapy, when properly administered by a physician fully trained and competent in this therapy. Chelation therapy is an office treatment which on average for 20 to 40 infusions runs an estimated cost between $2000-$4000 dollars. Thus, both the benefit-risk profile and the cost-effectiveness of chelation are likely superior over bypass and angioplasty. Although it has not been subjected to vast numbers of clinical trials, two meta-analysis suggest EDTA chelation therapy benefits cardiovascular symptoms in more than 4 out of 5 patients. Chappell and Stahl published an analysis on 22,765 patients from 19 clinical studies. A correlation coefficient of 87% between chelation therapy and improved cardiovascular symptoms based on testing was observed. According to a study conducted by Hancke and Flytlie on patients with atherosclerosis, of 65 patients who were waiting for bypass surgery and given chelation, only 7 patients still required bypass; of 27 patients previously scheduled for leg amputation, only 3 required surgery following chelation therapy!

Both bypass and angioplasty are invasive procedures that have significant risk, and both are highly expensive with poor cost-effectiveness. Chelation therapy, on the other hand, offers a non-invasive, cost-effective, and safer means of treating heart disease. Thus it appears logical to implement chelation therapy as the first method of treatment in cardiovascular disease and especially in those people heading towards bypass & angioplasty. Chelation therapy is most effective when used as part of a comprehensive, individualized program that also includes dietary and lifestyle revision, nutritional supplementation, exercise, and stress reduction.

References

1. Kidd PM. Integrative Cardiac Revitalization: Bypass Surgery, Angioplasty, and Chelation. Alt Med Rev 1998;3:1:4-17.
2. Bates MS. A critical perspective on coronary artery disease and coronary bypass surgery. Social Sci Med 1990;30:249-260.
3. Pocock SJ et al. Meta-analysis of randomized trials comparing coronary angioplasty to bypass surgery. Lancet 1995;346:1184-1189.
4. White HD. Angioplasty versus bypass surgery. Lancet 1995;346:1174-1175. [Letter].
5. Hlatky MA et al. Medical care costs and quality of life after randomized to coronary angioplasty or coronary bypass surgery. N Eng J Med 1997;336:2:92-98.
6. Schacter MB. Overview, historical background and current status of EDTA chelation therapy for atherosclerosis. J Advancement Med 1996;9:159-177.
7. Rozema TC. The protocol for the safe and effective administration of EDTA and other chelating agents for vascular disease, degenerative disease, and metal toxicity. J Advancement Med 1997;10:5-100.
8. Gordon GB, Vance RB. EDTA chelation therapy for atherosclerosis. History and mechanisms of action. Osteopathic Annals 1976;4:38-62.
9. Chappell LT, Stahl JP. The correlation between EDTA chelation therapy and improvement in cardiovascular function: a meta-analysis. J Advancement Med 1993;6:139-160.
10. Hancke C, Flytlie K. Benefits of EDTA in arteriosclerosis: a retrospective study of 470 patients. J Advancement Med 1993;6:161-170.