Authors
1 Department of Pharmacy, University Clinical Hospital, “Lozano Blesa,” Zaragoza, Spain
2 Department of Health Emergencies o61, Servicio Aragones de Salud, Zaragoza, Spain
3 Department of Pharmacy, Psychosocial Rehabilitation Center of Ntra, Zaragoza, Spain
Abstract
Objective: The objective of this study is to assess the association between exposure
to atorvastatin (ATV) and low-plasma folate (PF) status. Methods: The sample
consisted of patients admitted to the internal medicine service of a basic general
hospital, located in Zaragoza (Spain). We adopted a pharmacoepidemiological
case–control study design. For this, the number of treatment days (TDs) of all
the drugs part of their treatment during the study period was obtained from each
patient in the sample. The cases were comprised by the number of patient’s TDs
for which PF ≤3 mg/dl and the controls by the number of patient’s TDs for which
PF >3 mg/dl. To measure the strength of the association, the odds ratios (ORs)
were calculated. The Chi-square test, using the Bonferroni correction, was
used to calculate the statistical significance. Findings: The sample consisted of
640 polymedicated patients. The mean PF obtained were 8.0 ± 4.6 mg/dl and
2.1 ± 0.6 mg/dl, for the cases and controls, respectively; the total number of
TDs for the cases and controls were 7615 and 57899, respectively. We obtained
a U-shaped curve when representing the dose of ATV against the corresponding
ORs when comparing cases with control. Conclusion: Exposure to ATV at 10 or
80 mg is associated with an augmented risk of low folate status. We recommend
implementing guidelines for mandatory folic acid fortification in patients exposed
to ATV doses of 10 or 80 mg.
Keywords
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