Chelation Defined
A chelating agent is a compound that binds tightly to a metal ion through a ring structure. The
metal ion is inactivated and cannot enter into other chemical reactions. The metal ion is
excreted out of the body, usually through the kidneys/urine.

Free Radical Pathology, impaired electrons ( e.g. metal ions) cause excessive oxidation of
cholesterol plus inflammation of vessel walls causing plaque formation.

Metal Toxicity; treated with Lead BAL , Iron desterroxamine , Lead EDTA (ethylenediamine
tetracetic adic). Cardiovascular Disease; patients with lead toxicity improved after chelation. In
the US 75,000 patients per year receive chelation for cardiovascular disease. In Canada there
are in the area of 50 MDs that perform chelation.

EDTA is a synthetic amino acid that binds (chel = claw) metals; most excreted through kidneys.
EDTA is a strong anti-oxidant. It is available through I.V. , oral, suppositories.

EDTA & Cardiovascular Disease; according to current theories EDTA reduces LDL oxidation by
binding copper, iron and lead. EDTA acts as an antioxidant by binding metals thus reducing free
radicals. EDTA binds with calcium in plaques. EDTA depletes blood calcium level which
stimulates parathyroid hormone which releases calcium from plaques/bones.

Possible EDTA adverse effects; Renal Toxicity, Hypocalcemia, Hypoglycemia, hypotension,
trace metal and vitamin deficiencies, local venous symptoms, clotting parameters, febrile
episodes.

TACT Summary; coronary artery disease (CAD) is the leading cause of death. Current CAD
treatments include: lifestyle, medication, angioplasty and bypass surgery. National Center for
Complementary and Alternative Medicine (NCCAM), part of National Institutes of Health (NIH)
, and the National Heart, Lung and Blood Institute (NHLBI) recognize the clinical and public
need for a large scale trial of chelaton therapy and funded the trial ($30 Million).

TACT Summary con't; 30 weekly treatments, then 10 treatments approx monthly; follow up for
approx 2 years. Primary endpoints are all cause mortality, myocardial infarction, stroke,
hospitalization for angina, and coronary revascularization.

Specific Aims; to determine wheter chelation or high-dose supplements in patients with CHD
will reduce the incidence of clinical cardiovascular events. To determine whether chelation
and high-dose supplements have acceptable safety profiles.

TACT Design; 5 year randomized, double blind, placebo-controlled trial. Teasting the standard
chelation solution versus placebo. Testing the effects of a high-dose antioxidant vitamin and
mineral supplementation, versus a placebo.

How does TACT fit into Cardiovascular research? TACT is the largest chelation trial ever
conceived. TACT already has three times more patients than the total number previously
randomized in all other chelation trials together. TACT is testing the richest vitamin mixture
ever tested in a clinical trial.

TACT to date; 100 sites USA since August 2004, 1300 patients, Canadian sites December 2006,
1st Canadian patient March 2007.

Participant Screening; Greater than 50 years old. Heart attack more than 6 weeks ago. No
cigarette smoking past 3 months. No chelation therapy past 5 years. No allergic reaction to
components of chelation solution. No allergic reaction to vitamins or minerals. No coronary or
carotid revascularization within last 5 months. No planned revascularization. No symptomatic
or clinically evident heart failure. No hospitalization for heart failure in the past 6 months. No
stage II hypertension (BP>160/100). No inadequate venous access in upper extremities. No
abnormal baseline lab results (creatinine > 160, platelets <100,000) .No history of liver disease.
No disease of copper, iron or calcium metabolism. Ability to tolerate a weekly fluid load of
500cc over 3 hours. No non-coronary medical condition (e.g. cancer) likely to affect survival
within 4 years.

Study Participants Considerations; Ethical/altruistic, to prove or disprove a therapy which
helps others. Treatment vs. Placebo, Time/travel commitment. End of study 10 free treatment
for placebo patients. Each participant receives either $1000 or $4000 of treatment.