MRCP2-0432

A 65-year-old man arrives at the emergency department with severe chest pain in the central region. The pain started suddenly about an hour ago. The 12-lead ECG shows >2 mm of ST elevation in all anterior and lateral leads. The nearest primary angioplasty center is 140 minutes away, and there are no contraindications to thrombolysis.

Apart from the standard treatment for acute coronary syndrome (pain relief, aspirin, a heparin, and a P2Y12 inhibitor), what is the most appropriate approach for managing this patient?