Primary Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction with Acute Kidney Injury Caused by Cardiogenic Shock, Is it Really Safe?; A Case Report

Background: ST-elevation myocardial infarction (STEMI) is a life-threatening condition. STEMI condition accompanied by complications such as prolonged shock condition and become Acute Kidney Injury (AKI), it is still a question of whether to be treated conservatively or invasively. If PPCI was an option, how to prevent the worsening outcome is still an issue. We present the case of a woman, 53 years old with STEMI inferior onset 5 hours underwent PCI in acute kidney injury condition caused by cardiogenic shock. Objective: This study aimed to elaborate the safety of Primary Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction with Acute Kidney injury caused by Cardiogenic Shock Case Presentation: A 53 years old, woman, was referred from a private hospital with STEMI inferior Killip IV onset 5 hours with typical chest pain and azotemia. Creatinine serum was 3.4 mg/dl; eGFR 15 ml/m/1.73m2. Blood Gas Analyses show metabolic acidosis uncompensated. In the emergency room, she got hydration and inotropic drugs. After the PCI procedure, she was fallen into an altered mental status and shock condition. The laboratorium result in our hospital showed improvement of creatinine level to 1.6 mg/dl. We treated this patient for 9 days, with optimal medicaments and fluid therapy. On the last day of treatment, there is an improvement in clinical presentation and laboratorium results. Conclusion: Acute renal failure is a frequent complication in STEMI, leading to higher mortality, morbidity, and intrahospital complications. PPCI is a reperfusion strategy recommended by the guideline in the setting of myocardial infarction with cardiogenic shock. Proper management to prevent worsening of renal function in this condition is very important.