This study analyzes 39,864 patients with infarct-associated cardiogenic shock (AMICS), comparing outcomes between those treated with mechanical circulatory support devices (tMCS) like IABP, Impella, and V-A ECMO, versus standard care alone. Findings indicate higher in-hospital complications and mortality rates in patients receiving V-A ECMO and Impella compared to those treated with IABP or no tMCS. IABP use was associated with a survival benefit, highlighting the need for careful device selection in managing AMICS.