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MediumCardiologyST-elevation myocardial infarctionca-mccqe1ca-rcpsc-emca-rcpsc-im

A 69-year-old man presents to the emergency department with 90 minutes of crushing central chest pain radiating to his left arm. ECG shows 3 mm ST elevation in leads II, III and aVF with reciprocal ST depression in I and aVL. He received aspirin 160 mg chewed from paramedics. There is no contraindication to fibrinolysis and primary PCI is not available within 2 hours. According to contemporary guideline-based care, which is the most appropriate next step?

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