Despite advances in medical therapies and coronary revascularization, infarct-related cardiogenic shock remains a life-threatening emergency with high death rates.

Temporary mechanical circulatory support, including peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO), is a potential option for this condition as it can instantly improve hemodynamics while simultaneously providing gas exchange for acute cardiorespiratory failure.

However, this is an expensive and invasive strategy that requires large-bore vascular access and can result in serious complications including bleeding, peripheral ischemia, and stroke.

Since its introduction in 1972, there has been a marked increase in VA-ECMO use for cardiogenic shock, although whether it improves outcomes in these patients is still unknown.

Observational data have been limited by residual confounding, not allowing for causal interpretation.

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