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HardCardiologyST-elevation myocardial infarctionca-rcpsc-emca-rcpsc-imca-mccqe1

A 64-year-old man with 90 minutes of crushing central chest pain presents to a small rural hospital without PCI capability. ECG shows ST-elevation in leads II, III, and aVF. The nearest PCI centre is 3.5 hours away by ground and there is no immediate air transport. According to CCS STEMI guidance, what is the best reperfusion strategy?

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