A 62-year-old man presents to a rural emergency department 90 minutes after onset of central crushing chest pain. ECG shows 3 mm ST elevation in leads II, III, and aVF with reciprocal changes in aVL. The nearest percutaneous coronary intervention (PCI) centre is 3.5 hours away by road, with no access to air transport. According to Canadian STEMI guidance, what is the best reperfusion strategy?