Urinary Metal Levels after Repeated Edetate Disodium Infusions: Preliminary Findings

Zenith H. Alam, Francisco Ujueta, Ivan A. Arenas, Anne E. Nigra, Ana Navas-Acien and Gervasio A. Lamas
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Zenith H. Alam: Department of Medicine, Columbia University, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140, USA
Francisco Ujueta: Department of Medicine, Columbia University, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140, USA
Ivan A. Arenas: Division of Cardiology, Columbia University, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140, USA
Anne E. Nigra: Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA
Ana Navas-Acien: Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA
Gervasio A. Lamas: Department of Medicine, Columbia University, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL 33140, USA

IJERPH, 2020, vol. 17, issue 13, 1-9

Abstract: Environmentally acquired lead and cadmium are associated with increased cardiovascular disease risk. In the Trial to Assess Chelation Therapy, up to 40 infusions with edetate disodium over an approximately one-year period lowered the cardiovascular disease risk in patients with a prior myocardial infarction. We assessed whether a reduction in surrogate measures of total body lead and cadmium, post-edetate disodium urine lead and pre-edetate urine cadmium, could be detected after repeated edetate disodium-based infusions compared to the baseline. Fourteen patients with coronary artery disease received multiple open-label edetate disodium infusions. The urine metals pre- and post-edetate infusion, normalized for urine creatinine, were compared to urine levels pre and post final infusion by a paired t -test. Compared with the pre-edetate values, post-edetate urine lead and cadmium increased by 3581% and 802%, respectively, after the first infusion. Compared to baseline, post-edetate lead decreased by 36% ( p = 0.0004). A reduction in post-edetate urine lead was observed in 84% of the patients after the final infusion. Pre-edetate lead decreased by 60% ( p = 0.003). Pre-edetate lead excretion became undetectable in nearly 40% of patients. This study suggests that edetate disodium-based infusions may decrease the total body burden of lead. However, our data suggest no significant reduction in the body burden of cadmium.

Keywords: lead; cadmium; chelation; vascular disease; atherosclerosis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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