Saturday, August 05, 2006

NCCAM chelation study site tour part III

This is the third in a series of posts in which I will examine some of the study sites for the National Center for Complementary and Alternative Medicine (NCCAM) sponsored Trail to Assess Chelation Therapy (TACT). The purpose is to address questions about the quality of the research based on conditions at the study sites. The vast majority of sites are private clinics at remote locations across the U.S., raising questions about supervision, and many are alternative or holistic medicine clinics, raising questions about scientific qualifications and investigator bias.

The next study site we will examine on our tour is Wellness Works in Brandon Florida. The mission of Wellness Works is, in part, “to offer our patients an evaluation, treatment, and education based on the holistic model of body-mind-spirit.” Services offered include the assessment of hormone status via saliva testing, intravenous vitamin therapy to treat neurologic dysfunction and immune deficiency, and chelation therapy for atherosclerosis.

The chelation page of the Wellness Works web site describes chelation thusly: “Chelation therapy is also thought by many doctors to be effective in reducing plaque in the arteries. By softening ‘hardening’ of the arteries, this process makes them capable of carrying much more oxygen and nutrients to all the organs of the body.”

Because this seems to be a recurring misconception among TACT investigators, a comment on the pathophysiology of atherosclerosis is in order here. Although reducing the lipid content of atherosclerotic plaques would be expected to reduce the risk of coronary events, reduction of plaque size to enable more blood flow would not. In fact, highly stenotic plaques appear to be an uncommon cause of acute coronary syndrome compared to plaques producing milder degrees of stenosis. Moreover, softening of plaques is not beneficial, as softer plaques are more prone to rupture and cause acute coronary syndrome (Ayala TH-Cardiol. Clin.-1-Feb-2006;24(1):19-35).

Background: Part I; Part II.

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