A 48-year-old Aboriginal man presents to a remote nurse-led clinic 60 minutes after onset of severe central chest pain radiating to his jaw. ECG shows 3 mm ST elevation in leads V2-V4 with reciprocal changes inferiorly. The nearest PCI-capable hospital is 260 km away; retrieval will result in an expected first medical contact-to-balloon time of 3 hours. What is the most appropriate reperfusion strategy?