A 58-year-old male presents to the ED with chest pains. He is afebrile with a heart rate of 70 beats per minute, blood pressure 130/90 mm Hg, respirations 20 per minute. He is given appropriate therapy with aspirin, clopidogrel, unfractionated heparin and a beta-blocker. His ECG is below:
The nearest hospital capable of percutaneous coronary intervention is 80 minutes away. Which of the following is the most appropriate course of action?
A. Immediate transfer for primary PCI
B. Administration of a direct thrombin inhibitor
C. Administration of fibrinolytic therapy
D. Administration of fibrinolytic therapy and transfer for PCI (facilitated PCI)