A 58-year-old man presents to a small rural hospital in northern Ontario with 90 minutes of crushing central chest pain and diaphoresis. ECG shows 3 mm ST elevation in leads V2-V4. The nearest PCI-capable centre is 250 km away by road and the estimated door-in-door-out plus transfer time is 3.5 hours. There are no contraindications to fibrinolysis. What is the most appropriate reperfusion strategy?