C77. Primary Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction with Acute Kidney Injury caused by Cardiogenic Shock, Is it Really Safe?: A Case Report

ST-elevation myocardial infarction (STEMI) is a life-threatening condition. Timely treatment with Percutaneous Coronary Intervention (PCI) is a recommended management of STEMI. However, PCI in STEMI with Acute Kidney Injury (AKI) was a high-risk procedure with possibilities of worsening renal function.

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.

STEMI is a life-threatening condition caused by acute occlusion in the coronary artery. The guideline strongly recommended Primary Percutaneous Coronary Intervention in a patient with STEMI and cardiogenic shock. AKI in STEMI patients was a consequence of acute cardiac condition and its treatment. PPCI in AKI condition can improve renal function due to improvement of renal flow. But on the other side, it can worsen renal function due to contrast-related acute kidney injury. Proper management to prevent worsening of renal function is very important.