Journal of Research in Pharmacy Practice

Association Between Atorvastatin Exposure and Low Folate Status: A Case–Control Study

Authors

. Roberto Lozano 1
. Irati Apesteguía 2
. Alejandro Martínez 3

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

Atorvastatin
case–control
folate
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Journal of Research in Pharmacy Practice
Volume 11, Issue 3
Summer 2022
Pages 124-126

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