Evaluation of the Trial to Assess Chelation Therapy (TACT): The Scientific Process, Peer Review, and Editorial Scrutiny | Acute Coronary Syndromes | JAMA | JAMA Network
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Editorial
March 27, 2013

Evaluation of the Trial to Assess Chelation Therapy (TACT): The Scientific Process, Peer Review, and Editorial Scrutiny

Author Affiliations

Author Affiliations: Dr Bauchner (howard.bauchner@jamanetwork.org) is Editor in Chief, Dr Fontanarosa is Executive Editor, and Dr Golub is Deputy Editor, JAMA.

JAMA. 2013;309(12):1291-1292. doi:10.1001/jama.2013.2761

In this issue of JAMA, Lamas and colleagues1 report the results of the Trial to Assess Chelation Therapy (TACT). In this multicenter clinical trial, 1708 patients with previous myocardial infarction (MI) were randomized to receive 40 infusions of chelation solution vs placebo. After a median follow-up of 55 months, the primary end point (a composite of total mortality, recurrent MI, stroke, coronary revascularization, or hospitalization for angina) occurred in 222 patients (26%) in the chelation group and in 261 patients (30%) in the placebo group, with the major between-group difference involving fewer coronary revascularization procedures in the chelation group (15%) than in the placebo group (18%). The authors conclude that although chelation therapy modestly reduced the risk of a composite of adverse cardiovascular outcomes, the results “are not sufficient to support the routine use of chelation therapy for treatment of patients who have had an MI.”

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