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ModerateCardiovascularST-elevation myocardial infarctionuk-plab-1

A 62-year-old man presents to the emergency department 90 minutes after the onset of central crushing chest pain radiating to his left arm. ECG shows 3 mm ST elevation in leads V2–V4 with reciprocal depression in the inferior leads. He has no contraindications to reperfusion therapy. The nearest primary PCI centre is 45 minutes away by blue-light ambulance. What is the most appropriate next step in his management?

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