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ModerateCardiovascularST-elevation myocardial infarctionuk-plab-1

A 60-year-old man presents to the emergency department 90 minutes after the sudden onset of central crushing chest pain radiating to his left arm. An ECG shows 3 mm ST elevation in leads V2–V5. He has no contraindications to anticoagulation or thrombolysis. A primary PCI-capable centre 30 minutes away can accept him immediately. What is the most appropriate next step in his management?

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