A 59-year-old man presents 45 minutes after onset of severe central chest pain radiating to his left arm. ECG shows 3 mm ST elevation in leads V2-V5. He is at a small rural hospital without percutaneous coronary intervention (PCI) capability. The nearest PCI-capable centre is 220 km away by road; estimated transfer time is 2.5 hours. What is the most appropriate reperfusion strategy?