Urinary Metal Levels after Repeated Edetate Disodium Infusions: Preliminary Findings

Area of Science:

• Environmental Health
• Cardiovascular Medicine
• Toxicology

Background:

• Environmentally acquired lead and cadmium are linked to increased cardiovascular disease (CVD) risk.
• The Trial to Assess Chelation Therapy (TACT) demonstrated that edetate disodium infusions reduced CVD risk in patients with prior myocardial infarction.
• The study aimed to evaluate the impact of repeated edetate disodium infusions on lead and cadmium body burden.

Purpose of the Study:

• To assess if repeated edetate disodium infusions reduce surrogate measures of total body lead and cadmium.
• To compare post-infusion urine lead and cadmium levels to baseline measurements.

Main Methods:

• Fourteen patients with coronary artery disease received multiple open-label edetate disodium infusions.
• Urine metal levels (lead and cadmium), normalized for creatinine, were measured pre- and post-infusion.
• Paired t-tests were used to compare pre- and post-infusion urine metal levels before and after the final infusion.

Main Results:

• Post-edetate urine lead and cadmium significantly increased after the first infusion.
• Compared to baseline, post-edetate urine lead decreased by 36% (p = 0.0004), with 84% of patients showing a reduction after the final infusion.
• Pre-edetate lead decreased by 60% (p = 0.003), becoming undetectable in nearly 40% of patients.
• No significant reduction in the body burden of cadmium was observed.

Conclusions:

• Edetate disodium infusions may effectively decrease the total body burden of lead.
• The study suggests that edetate disodium chelation therapy is not effective in reducing the body burden of cadmium.
• Further research is warranted to explore the long-term effects and optimal protocols for edetate disodium therapy in managing heavy metal toxicity and cardiovascular risk.