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Rheumatoid ArthritisRheumatoid arthritis (RA) is a chronic inflammatory disorder that primarily affects the synovial tissues in the joints. Reports from the Centers for Disease Control and Prevention (CDC) suggest that about 1.3 million people in the United States suffer from this disease. Out of every 100,000 people, 41 are diagnosed with RA every year. It is estimated that the number of people with arthritis is expected to reach 67 million by the end of 2030.

In most cases, women are about two-and-a-half times more likely to suffer from this condition than men. There are different signs and symptoms associated with this condition and these symptoms may first appear between the ages 30-60 in women and somewhat later in life in men. Some of the main symptoms include chronic pain, joint swelling and inflammation, fatigue, joint stiffness and weight loss. The type and severity of symptoms may vary from one person to another.

Rheumatologists treating arthritis patients or medical coding companies that bill for them have to report the correct diagnostic and procedural codes on the medical claims.

The following ICD-CM codes can be used

  • ICD-9-CM – 714.0 Rheumatoid arthritis
  • ICD-10-CM – M06.9 Rheumatoid arthritis, unspecified

The lifetime risk of developing RA is about 4% in women and 3% in men. The potential risk factors include genetics, hormonal changes, lifestyle habits, age, sex and other environmental factors. Rheumatoid arthritis increases the risks of heart attack and stroke. It is estimated that the risk of heart attack increases 60% one year after diagnosis than it is without the disease.

A new study reports that patients diagnosed with rheumatoid arthritis are at increased risk of suffering a surprise heart attack. The study results presented at ICNC 12 (by Dr Adriana Puente, a cardiologist at the National Medical Centre “20 de Noviembre” ISSSTE in Mexico City, Mexico) found that the risk increases even when the patients experienced zero symptoms and was independent of traditional cardiovascular risk factors such as smoking and diabetes.

As part of the study, researchers analyzed the presence of ischaemia and infarction secondary to atherosclerotic disease (coronary artery disease) in about 91 patients with RA and other traditional cardiovascular risk factors, but no symptoms of heart disease. Researchers measured RA disease activity, inflammatory markers and risk factors among all patients.

  • It was found that 55% of patients suffered dyslipidemia (high blood lipids), 32% had hypertension, 14% were smokers and 10% had Type 2 diabetes.
  • About one quarter (24%) of patients had abnormal Gated SPECT (indicating ischaemia or infarction).
  • Researchers found so significant co-relation between the presence of ischaemia or infarction and disease activity, inflammatory markers and cardiovascular risk factors.

The study findings highlight that one quarter of patients with RA and no symptoms of heart disease do have coronary heart disease (as indicated by the presence of myocardial ischaemia or infarction in the study). This means they could suffer a heart attack without prior warning. About 90% of study participants were women aged 59 years (on an average) who had a similar frequency of cardiovascular risk factors as the general population.

The study results signify the importance of conducting routine diagnostic tests in patients with RA to identify whether they have cardiovascular disease specifically atherosclerotic coronary artery disease (ischaemia or myocardial infarction) even though they do not have any symptoms and risk factors. Early diagnosis and treatment of RA can help control the disease symptoms and prevent disability. Researchers emphasize the need for educating patients with RA that they have a higher tendency to heart disease and provide advice on how to control their disease symptoms in a better manner. This in turn will help prevent and reduce cardiovascular risk factors.