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Record W1993127189 · doi:10.1001/jama.287.4.481

Chelation Therapy for Ischemic Heart Disease

2002· article· en· W1993127189 on OpenAlexaffabout
Merril L. Knudtson

Bibliographic record

VenueJAMA · 2002
Typearticle
Languageen
FieldMedicine
TopicCardiovascular Syncope and Autonomic Disorders
Canadian institutionsFoothills Medical Centre
Fundersnot available
KeywordsMedicinePlaceboCoronary artery diseaseAnginaMyocardial infarctionInternal medicineRandomized controlled trialChelation therapyST depressionDepression (economics)Ejection fractionCardiologySurgeryHeart failurePathology

Abstract

fetched live from OpenAlex

CONTEXT: Chelation therapy using EDTA is an unproven but widely used alternative therapy for ischemic heart disease. OBJECTIVE: To determine if current EDTA protocols have a favorable impact on exercise ischemia threshold and quality of life measures in patients with stable ischemic heart disease. DESIGN: Double-blind, randomized, placebo-controlled trial conducted between January 1996 and January 2000. SETTING: Participants were recruited from a cohort of cardiac catheterization patients and the practices of cardiologists in Calgary, Alberta. PARTICIPANTS: We screened 3140 patients, performed a qualifying treadmill test in 171, and enrolled 84. Entry criteria included age at least 21 years with coronary artery disease proven by angiography or a documented myocardial infarction and stable angina while receiving optimal medical therapy. The required treadmill test used a gradual ramping protocol and patients had to demonstrate at least 1-mm ST depression. INTERVENTIONS: Patients were randomly assigned to receive infusion with either weight-adjusted (40 mg/kg) EDTA chelation therapy (n = 41) or placebo (n = 43) for 3 hours per treatment, twice weekly for 15 weeks and once per month for an additional 3 months. Patients in both groups took oral multivitamin therapy as well. MAIN OUTCOME MEASURE: Change from baseline to 27-week follow-up in time to ischemia (1-mm ST depression). RESULTS: Thirty-nine patients in each group completed the 27-week protocol. One chelation patient had therapy discontinued for a transient rise in serum creatinine. The mean (SD) baseline exercise time to ischemia was 572 (172) and 589 (176) seconds in the placebo and chelation groups, respectively. The corresponding mean changes in time to ischemia at 27 weeks were 54 seconds (95% confidence interval [CI], 23-84 seconds; P<.001) and 63 seconds (95% CI, 29-95 seconds; P<.001), for a difference of 9 seconds (95% CI, -36 to 53 seconds; P =.69). Exercise capacity and quality of life scores improved by similar degrees in both groups. CONCLUSION: Based on exercise time to ischemia, exercise capacity, and quality of life measurements, there is no evidence to support a beneficial effect of chelation therapy in patients with ischemic heart disease, stable angina, and a positive treadmill test for ischemia.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.001
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.002
Threshold uncertainty score0.007

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0020.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.019
GPT teacher head0.250
Teacher spread0.231 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations111
Published2002
Admission routes2
Has abstractyes

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