Učinak kelata na bazi EDTA na pacijente s dijabetesom i preboljelim infarktom

Klara Crnjac, dr. med. (prenijeto s PlivaMed)

Dijabetičari stariji od 50 godina koji su preživjeli infarkt miokarda imali su značajno manji broj kardiovaskularnih incidenata nakon što su primali kelate na bazi EDTA (etilendiamintetraoctena kiselina), pokazala je subanaliza velike studije Trial to Assess Chelation Therapy (TACT) objavljene u časopisu Circulation: “Cardiovascular and Quality Outcomes”.
Primarni cilj ove randomizirane, dvostruko slijepe kliničke studije bio je utvrditi učinkovitost EDTA-kelacijske terapije kod 1708 pacijenata s koronarnom bolešću srca s ili bez dijabetesa. Primarni su rezultati pokazali malo, ali značajno smanjenje kardiovaskularnih incidenata u svih pacijenata liječenih s EDTA. No, subanalizom koja je uključila 633 pacijenta – dijabetičara, nađen je vrlo značajno manji broj kardiovaskularnih incidenata (smrti, ponovnih infarkta, moždanih udara, koronarne revaskularizacije te hospitalizacija zbog angine pectoris). Pacijenti su bili stariji od 50 godina i preboljeli su infarkt miokarda. Od ukupno 633 bolesnika, 322 su primala 40 infuzija otopine kelata na bazi EDTA, a 311 njih placebo. Autori ističu kako su nakon detaljnih sekundarnih analiza u pacijenata s dijabetesom koji su primali kelate pronašli četrdesetpostotno smanjenje ukupne smrtnosti te 40% manji broj recidiva infarkta miokarda.
Zanimljivi rezultati ove studije otvaraju pitanja o novim-starim načinima liječenja i sekundarne prevencije kardiovaskularnih bolesti u pacijenata s dijabetesom. Potrebne su dodatne studije koje bi pobliže objasnile mehanizam djelovanja kelacijske terapije i potvrdile njihov učinak u patofiziologiji i liječenju ovih bolesti.
Kelacijska terapija je postupak kojim se iz organizma uklanjaju teški metali (aluminij, arsen, bakar, željezo, živa, olovo). Za kelacijsku terapiju koriste se spojevi poput etilen diaminotetraoctene kiseline (EDTA), dimerkaptosukcinata (DMSA) te 2,3-dimerkapto-1-propansulfonata (DMPS). Kelirajući agens se može primijeniti intravenozno, intramuskularno ili oralno, no najdjelotvornije je intravenozno. Nakon što kelirajući agens na sebe veže teški metal, taj se metal se izlučuje iz tijela. U isto vrijeme se iz organizma izlučuju vitamini C i E te ih je stoga potrebno nadoknaditi. Kelacijska terapija trenutno nije odobrena od strane FDA (Food and Drug Administration) za liječenje kardiovaskularnih bolesti, no njezina uporaba za liječenje srčanih bolesti u SAD-u raste.

Escolar E, Lamas GA, Mark DB, et al. The effect of an EDTA-based chelation regimen on patients with diabetes mellitus and prior myocardial infarction in Trial to Assess Chelation Therapy (TACT). Circ Cardiovasc Qual Outcomes 2014; DOI:10.1161/CIROUTCOMES.113.0000663.

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