Despite immediate coronary revascularization, mortality of patients experiencing infarct-related cardiogenic shock (AMICS) remains high [1]. Over the past decade, there has been a growing interest in the use of short-term mechanical circulatory support (STMCS), particularly extracorporeal life support (ECLS), in AMICS [2]. Presently, both the International Society for Heart and Lung Transplantation/Heart Failure Society of America and the European Society of Cardiology recommend the consideration of STMCS in cardiogenic shock (CS), serving as a bridge-to-recovery/-to-decision/-to-bridge, with a class II-C and IIa-C, respectively [3, 4]. Recent randomized controlled trials (RCTs), addressing the potential benefit of ECLS in CS classified as Society for Cardiovascular Angiography and Interventions (SCAI) stage C or higher, have been reported. The ECMO–CS trial (n = 122) [5] showed no superiority of ECLS in hospital mortality, while the EURO SHOCK trial was terminated prematurely due to slow enrollment, preventing conclusive findings from the available data. [6]. The most expansive RCT to date, ECLS–SHOCK (n = 417) [7], showed no differences in 30-day mortality (47.8% vs 49% p = 0.81) or secondary efficacy outcomes. Notably, results were consistent across pre-specified subgroups and ECLS was not associated with hemodynamic stabilization but with more complications (peripheral ischemic vascular complications and bleeding).