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HardCardiology, Emergency, Rural MedicineST-elevation myocardial infarctionca-mccqe1ca-rcpsc-em

A 52-year-old man from a remote northern community presents to a nursing station with an anterior ST-elevation myocardial infarction 90 minutes after symptom onset. The nearest PCI centre is 6 hours away by ground and 3 hours by air if weather permits. According to Canadian STEMI care principles, what is the best immediate reperfusion strategy?

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