A 64-year-old man presents to a rural emergency department 90 minutes after sudden onset central chest pain radiating to his left arm, associated with nausea and diaphoresis. ECG shows 3 mm ST elevation in leads V2-V4 with reciprocal ST depression in inferior leads. The nearest PCI-capable centre is 4 hours away by road and retrieval is delayed due to bad weather. What is the most appropriate immediate reperfusion strategy?