A 48-year-old male with a history of diabetes, obesity and tobacco use presents with severe substernal chest pressure and shortness of breath. His temperature is 99.0, blood pressure 90/60 mm Hg, heart rate 90 beats per minute, respirations 20 per minute and oxygen 90% on room air. His chest X-ray shows significant pulmonary edema. Laboratory studies reveal a troponin of 10.5, creatinine of 1.4 and hemoglobin of 11.0. His ECG is below:
Which of the following medical therapies is NOT appropriate at this time?
E. Low molecular weight heparin