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HardEmergencyST-elevation myocardial infarction reperfusionca-mccqe1ca-rcpsc-emca-rcpsc-im

A 59-year-old man with chest pain lasting 90 minutes presents to a rural emergency department without percutaneous coronary intervention capability. ECG shows anterior ST-elevation myocardial infarction. The nearest PCI-capable centre is 3 hours away by ground even with rapid transfer. What is the most appropriate reperfusion strategy?

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