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March 14, 2013

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I must agree with BV that the variability in diet is a major confounding factor that can swing the result either way. Additionally, multivitamins supplements have been shown to not easily taken up by the body through PO route and how you take it really has a big difference in what is actually taken up by your body. Large number of patients trial still require good design to answer the question at hand.

I think that there needs to be more information before conclusions can be made. Both study groups took aspirin, BP lowering agents and cholesterol lowering agents. But, how compliant were the patients to the medication therapy? This can be a big factor in the results of this study. I also wonder if there was standardization in the multivitamins. So, I would like to see results from other studies to find out if the same results are seen.

I agree with Zach's comment about Chelation therapy being a buzzkill and sticking to other options to reduce heart complications. Forty three-hour sessions over 18 months sounds way too time consuming and complicated. I have a hard time making it to my PCP once a year!

I agree with bp, it seems like it would be difficult to tell if one is actually deficient in many of the vitamins available in a multivitamin. Tests are not done frequently for vitamin or mineral levels, with the exception of iron and vitamin D. I wonder of the base level of vitamins in the patients studied had an impact on the results of the trial.

I was wondering about the same thing: why they choose chelation and multivitamins, not standardized therapies, for the study.

Now I am thinking maybe because standardized therapies have shown reduction on heart complications? According to the way they set up the study, standardized therapies can mask efficacy of multivitamins.

Multivitamins seem to be getting more and more controversial lately, since we're hearing about more trials where supplementation doesn't seem to help unless the patient is actually vitamin deficient. However, how many people actually know if they are deficient? Not many, at least beyond vitamin D! And from my experience, most physicians are more likely to just tell someone to take a multivitamin that do a lot of tests for specific deficiencies (I'm not trying to offend any physicians out there - this is just my experience!). With a family history of high cholesterol and heart disease, I had trouble even getting a physician to check my cholesterol, just because "you aren't 40 yet" (and the recommendation is to start at age 20 . . .), let alone try to get them to check trace elements!

I'd never heard about chelation therapy for heard disease either! I wonder what sort of response the chelation therapy by itself (+ placebo) had. I haven't been able to locate the trial yet, so I wonder if it wasn't as effective as with the multivitamins. Or why would the multivitamins make the chelation therapy more successful? Still, that's a lot of time to spend for the therapy - and a lot of access needed. Sounds like a recipe for possible infections, as well as a pain.

This study is interesting, however I am sure diet is a major confounding variable in a study like this (i.e. if patients receiving the high dose multivitamin were eating foods high in saturated fats and salts daily). I agree that further research is necessary on this topic. I am a big proponent of getting the vitamins and minerals needed from a daily diet rather than in the form of a pill. I think it is a common misconception today that one can skip out on nutritious foods as long as one takes a daily multivitamin. I agree with the comment posted by Zach, that the Mediterranean diet seems to be more promising as of right now in terms of providing benefit to heart health.

In the case of multivitamin use, it is important to relay to the patient that most of the vitamins do not get absorbed and are excreted in the urine. And isn’t there a contradiction here? Using a multivitamin with calcium and then a chelation agent to remove excess calcium. I think it is better to encourage a vitamin-rich diet with fruits and vegetables for most patients and those with certain deficiencies be supplemented as needed.

I think this is an interesting topic, who would have thought chelation therapy could be used for heart disease, but more research needs to be done. There seems to be a lot of holes in the article and I have a lot of questions about specifics after reading the summary. As mentioned I didn't see a link for the article but I would be very interested in looking at it more closely.

I am surprised that this study did not standardize aspirin therapy or blood pressure medication for this study. By saying "the vast majority" were using aspirin or antihypertensives, it makes me wonder how many patients in each group were not using these standard treatments. I did not see a link to the study in this article to verify the treatments patients were using myself. I feel this could potentially create a significant amount of imbalance between the study groups.

Chelation therapy sounds promising until you read the fine print: Chelation therapy consisted of 40 three-hour sessions with the IV infusion spread over 18 months.

So you have to get 120 hours of IV therapy over a year and a half...or 1.5 hours per week. Major buzzkill. I think I'll stick with the Mediterranean Diet for hearth health plan that was mentioned two weeks ago. :)

I have heard about chelation therapy in metal toxicity and kidney dysfunction, but its use in heart disease is new to me! This is very intriguing. I'm curious whether multivitamin administration and chelation therapy were separated by at least two hours to prevent interactions.

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