Possible use of miRNAs-146a and -499 expression and their polymorphisms as diagnostic markers for rheumatoid arthritis.

Rheumatoid arthritis (RA) is a systemic autoimmune disorder affecting the peripheral joints. Different microRNAs had been investigated in RA including miRNA-146a meanwhile, miRNA-499 there were no studies to prove its expression in RA serum samples. This study was performed to investigate expression of both miRNAs-146a and -499 and their polymorphisms in Egyptian patients with RA and to evaluate their relationship with clinico-pathological data. The present study includes 108 subjects classified into two main groups: 52 RA patients and 56 unrelated healthy controls. RA patients were subclassified according to DAS28 score into inactive (23 patients) and active (29 patients). Quantitative expression of serum miRNA-146a, miRNA-499 as well as their Genotyping rs2910164 (C/G) and rs3746444 (T/C), respectively, were done to all subjects using real-time PCR. Serum miRNA-146a and -499 were significantly over expressed in RA patients, but they were not correlated to disease activity. Serum miRNA-146a was negatively correlated with anti-nuclear antibodies (ANA). miRNA-146a (rs2910164) genotyping revealed that the GG genotype and the frequency of the G allele were significantly higher in RA patients compared to the controls. miRNA-499 (rs3746444), genotyping revealed that the CC genotype and the frequency of the C allele were significantly higher. It can be concluded that both miRNAs-146a and -499 can be used as diagnostic markers for RA patients. Both miRNA-146a (rs2710164) and miRNA-499 (rs3746444) were significantly associated with RA susceptibility. The C allele of miRNA-146a (rs2710164) can be considered to be protective. On the other hand, the C allele of miRNA-499 (rs3746444) was significantly associated with RA susceptibility.

Impact of FokI (rs10735810) and BsmI (rs1544410) on Treatment of Chronic HCV Patients With Genotype 4.

BACKGROUND AND AIM: Chronic infection with hepatitis C virus (HCV) is a huge problem both globally and at the level of the individual patient. Our aim is to detect the influence of vitamin D receptor gene polymorphisms (BsmI and Fok1) and vitamin D level in HCV patients under treatment with interferon. SUBJECT AND METHODS: Blood samples were taken from 103 HCV patients all of them are genotype 4. They were divided into responders (n = 63) and nonresponders (n = 40) according to their response to interferon treatment. Also 120 subjects with matched age and sex were enrolled as controls. All subjects were subjected to history taking, general examination, liver function tests, hepatitis markers, HCV quantitation by real-time polymerase chain reaction (PCR), DNA extraction from whole blood, PCR-restriction fragment length polymorphism (RFLP) for genotyping, and quantitation of vitamin D level by ELISA. RESULTS: There were significant differences between responders and nonresponders in the mean values of vitamin D (P = 0.001) as well as the prevalence of single nucleotide polymorphism (SNP) BsmI (Bb) (P = 0.02). Meanwhile, no significant differences in Fok1 genotype between responders and nonresponders to interferon therapy of HCV patients in all genotypes [FF, Ff, ff) (P = 0.34, 0.091, and 0.43), respectively. CONCLUSION: BsmI and vitamin D level in chronic liver disease patients are predictors of response to combination therapy of HCV.

The association between RANKL and Osteoprotegerin gene polymorphisms with breast cancer.

Breast cancer is the most common cause of cancer death among women (522,000 deaths in 2012). Imbalance between RANKL and OPG is observed in many cancers, including breast cancer. Consequently, SNPs in the genes of RANKL and OPG may be involved in breast cancer development. This study included 276 subjects. Group I (n = 100) healthy females as a control group, group II (n = 96) breast cancer patients without bone metastases, and group III (n = 80) breast cancer patients with bone metastases. RANKL rs9533156, OPG rs2073618, and OPG rs2073617 SNPs and their serum protein levels were studied for a possible association with breast cancer development. The allele frequency [(OR: 4.832 CI 2.18-10.71, P = 0.001) and genotype distribution (P = 0.001)] of OPG SNP rs2073618 showed a highly significant difference between breast cancer patients and healthy controls. The allele C is more common in breast cancer patients. The allele frequency [(OR: 0.451 CI 0.232-0.879, P = 0.018) and genotype distribution (P = 0.003)] of RANKL SNP rs9533156 differed significantly between breast cancer patients and healthy controls. The allele T is more common in breast cancer patients. The allele frequency [(OR: 0.36 CI 0.184-0.705, P = 0.002) and genotype distribution (P = 0.011)] of OPG SNP rs2073617 differed significantly between breast cancer patients and healthy controls. The allele T is more common in breast cancer patients. The C allele of OPG SNP rs2073618 may be associated with breast cancer development. No association was found between any of the SNPs and the serum protein levels of RANKL and OPG.

Single-nucleotide polymorphisms of IL-10 and IL-28B as predictors of the response of IFN therapy in HCV genotype 4-infected children.

BACKGROUND AND AIMS: Single-nucleotide polymorphisms (SNPs) in the IL-10 gene (-1082 [rs1800896], -819 [rs3021097], and -592 [rs1800872]) and the IL-28B gene (rs12979860) in adults were shown to be associated with hepatitis C virus (HCV) clearance. The present study aimed to investigate the possible association of SNPs of IL-10 and IL-28B in predicting the treatment response of HCV genotype 4 in pediatric patients. PATIENTS AND METHODS: A restriction fragment length polymorphism-polymerase chain reaction and real-time polymerase chain reaction techniques were used to genotype 34 pediatric patients with HCV genotype 4 for IL-10 and IL-28B SNPs, respectively. Patients received pegylated interferon-α/ribavirin for 48 weeks subdivided according to their response to treatment into responders and nonresponders; also, 20 healthy individuals served as controls. RESULTS: A significant difference (P < 0.005) was observed in SNP of IL-28B rs12979860 frequencies between responders and nonresponders. In responders, CC genotype had greater frequency than CT and TT genotypes (60%, 30%, 10%), respectively, with C allele in its homozygous (CC) genotype more likely to respond to treatment than in its homozygous (TT) genotypes. SNPs of IL-10 at -819 (rs3021097) showed significant differences in their genotype frequencies between responders and nonresponders to therapy, and TT genotype had greater frequency in responders than CT and CC (55%, 20%, 25%), respectively. Genotypes with T allele (CT/TT) showed higher rates of response than those with no T allele (CC). CONCLUSIONS: SNPs of the IL-28B gene at (rs12979860) CC genotype as well as the IL-10 gene SNPs at -819 (rs3021097)TT genotype can be used for predicting response to treatment before patients are prescribed the expensive pegylated interferon-α/ribavirin therapy.

Possible Role of lncRNA MEG3-microRNA-21 and Endoplasmic Reticulum (ER) Stress Proteins in the Pathogenesis of Psoriasis Vulgaris.

Background: Psoriasis is a chronic inflammatory immune mediated disease arising from interaction between genetic risk variants and the environment. Maternally expressed gene3 (MEG3) is a long noncoding RNA (lncRNA) known for gene transcription regulation and inhibiting proliferation. MEG3 competes with microRNA (miRNA-21) influencing cell proliferation and apoptosis balance. Endoplasmic reticulum (ER) stress proteins promote cell survival via unfolded protein response (UPR) influenced by MEG3. We aimed to detect the possible role of MEG3, miRNA-21 and ER stress proteins in pathogenesis of psoriasis vulgaris. Methods: Human GRP78, ATF6, caspase3 tissue levels were assayed by Enzyme Linked Immunosorbent Assay (ELISA). Assessment of long non-coding MEG3 and miRNA 21 expressions was done by quantitative real time polymerase chain reaction (qRT-PCR). Results: Expression of MEG3 was significantly downregulated, while miRNA-21 was remarkably upregulated, ER stress proteins GRP78, ATF6, and caspase 3 all showed low levels in homogenized psoriatic lesions when compared to normal skin. miRNA 21 and MEG3 were identified as possible diagnostic markers for psoriasis vulgaris. Discussion: MEG3 is barely expressed in psoriatic lesions while miRNA-21 expression is remarkably elevated but when correlated to each other there was unexpected positive correlation. MEG3 and miRNA-21 were identified as possible diagnostic markers for psoriasis. Undifferentiated psoriatic lesions have very weak UPR.

Assessment of hemodynamics, blood gases, and lung histopathology of healthy Pig model on two different mechanical ventilators.

In response to COVID-19 global crisis and arising from social responsibility, efforts have been exerted to promptly research, develop and manufacture ICU ventilators locally to meet the spike in demand. This study aimed at : Evaluating the safety and performance of a newly developed mechanical ventilator; EZVent compared to a commercial ventilator regarding hemodynamics, arterial blood gases (ABG), lung inflammatory markers, and histopathology in a healthy pig model using three different ventilation modes. Methods: Eight adult male pigs were anesthetized and randomly assigned into two equal groups: Commercial vent and EZVent group, the animals of which were ventilated using a standard commercial ventilator and EZVent, respectively. On every animal, three ventilation modes were tested, each mode for 30 min: CMV-VC, CMV-PC, and CPAP-PS modes. Vital signs, ECG, Lung Mechanics (LM), and ABG were measured before ventilation and after 30 min of ventilation of each mode. After animals' euthanasia, histological examinations of lung samples including morphometric assessment of alveolar edema, alveolar wall thickening, and the mean number of inflammatory cellular infiltrate/cm2 of lung tissue were analyzed. TNF-α and Il-6 expression and localization in lung tissue were assessed by western blot and immunohistochemistry. Results: The vital signs, LM, ABG, morphometric analysis, and histopathological score during the different ventilation modes showed non-significant differences between the study groups. TNF-α and IL-6 were minimally expressed in the bronchiolar epithelium and the alveolar septa. Their increased expression level was insignificant. Conclusion: EZVent is equivalent to the commercial ventilator regarding its safety and efficacy.

Standalone hybrid PV/wind/diesel-electric generator system for a COVID-19 quarantine center.

This work is motivated by the need in overcoming the electricity crisis in Gaza, which is initiated due to political reasons and the spread of COVID-19. Building quarantine centers is one of the most important means used in combating the COVID-19, but connecting these centers to the electricity distribution network at the appropriate time is not always possible and increases the burden on the local utility company. This article proposed a hybrid off-grid energy system (HES) to effectively energize the quarantine COVID-19 center in Gaza economically and environmentally. To achieve this aim, the estimated load profile of the quarantine center is fed to the HOMER-Pro program. In addition, the various systems components are introduced to the program, then modeled, and optimized. The developed approach was tested using a real case study considering realistic input data. HOMER-Pro program is used to simulate and optimize the system design. The results revealed the potential of the HES to provide environment-friendly, cost-effective, and affordable electricity for the studied quarantine center, as compared to just the diesel generators system. For the considered case study, it is found that the PV-wind-diesel generators HES can cover the connected load with the lowest cost ($ 0.348/kWh) in comparison to other possible HES structures. Taking into consideration the price of harmful emissions, the wining system shows a reduction of 54.89% of the cost of energy (CoE) compared to other systems. For the considered case study, it is found that a combination of 150 kW PV, 200 kW wind, and two diesel generators with capacities of 500 and 250 kW can hold 100% of the electrical load required to keep the quarantine COVID-19 center in operation. The initial capital cost of this HES is $510,576 where the share of wind energy, solar PV, inverter, and diesel-electric generators are $320,000, $83,076, $25,000, and $82,500, respectively. The replacemen cost ($55,918) is due to diesel generators. The total operation and maintainance cost (O&M) is $268,737, that is, 25.6% for wind turbines, 1.2% for inverters, and 70.7% for diesel electric generators. The PV/wind/diesel generators HES generate 1,659,038 kWh of electricity. The total energy requirement of 1,442,553 kWh, which means a surplus of 212,553 kWh of energy/year. The total energy (kWh) is an integration of energy sources which are 427,276 (25.8%), 274,500 (16.5%), and 857,263 (57.7%), due to wind, solar and diesel generators respectively. The cost of yearly consumed fuel is $437,828.769. The payback period for the winning system is 1.8 years. Finally, it is proved that the developed approach gives a reasonable solution to the decision-makers to find a fast, economic and reliable solution to energize the quarantine centers.

Outcomes and risk factors for death in patients with coronavirus disease-2019 (COVID-19) pneumonia admitted to the intensive care units of an Egyptian University Hospital. A retrospective cohort study.

BACKGROUND: The characteristics, outcomes, and risk factors for in-hospital death of critically ill intensive care unit (ICU) patients with coronavirus disease-2019 (COVID-19) have been described in patients from Europe, North America and China, but there are few data from COVID-19 patients in Middle Eastern countries. The aim of this study was to investigate the characteristics, outcomes, and risk factors for in-hospital death of critically ill patients with COVID-19 pneumonia admitted to the ICUs of a University Hospital in Egypt. METHODS: Retrospective analysis of patients with COVID-19 pneumonia admitted between April 28 and July 29, 2020 to two ICUs dedicated to the isolation and treatment of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in Cairo University Hospitals. Diagnosis was confirmed in all patients using real-time reverse transcription polymerase chain reaction on respiratory samples and radiologic evidence of pneumonia. RESULTS: Of the 177 patients admitted to the ICUs during the study period, 160 patients had COVID-19 pneumonia and were included in the analysis (mean age: 60 ± 14 years, 67.5% males); 23% of patients had no known comorbidities. The overall ICU and hospital mortality rates were both 24.4%. The ICU and hospital lengths of stay were 7 (25-75% interquartile range: 4-10) and 10 (25-75% interquartile range: 7-14) days, respectively. In a multivariable analysis with in-hospital death as the dependent variable, ischemic heart disease, history of smoking, and secondary bacterial pneumonia were independently associated with a higher risk of in-hospital death, whereas greater PaO2/FiO2 ratio on admission to the ICU was associated with a lower risk. CONCLUSION: In this cohort of critically ill patients with COVID-19 pneumonia, ischemic heart disease, history of smoking, and secondary bacterial pneumonia were independently associated with a higher risk of in-hospital death.

Stent boost enhancement compared to intravascular ultrasound in the evaluation of stent expansion in elective percutaneous coronary interventions.

BACKGROUND: Stent underexpansion is a major risk factor for in-stent restenosis and acute in-stent thrombosis1Intravascular ultrasound (IVUS) is one of the standards for detection of stent underexpansion (de Feyter et al. 1999; Mintz et al., 2001). StentBoost (SB) enhancement allows an improved angiographic visualization of the stent (Koolen et al., 2005). AIM OF WORK: Comparison of stent expansion by IVUS and SB enhancement and detection of value of SB to guide dilatation post stent deployment. METHODOLOGY: IVUS, SB enhancement and QCA were done in 30 patients admitted for elective stenting procedures .We compared measurements of mean ±standard deviations of (Max SD, Min SD, Mean SD, stent symmetry index) using IVUS, SB and QCA after stent deployment and after postdilatation whenever necessary to optimize stent deployment. The Stent symmetry index was calculated [(maximum stent diameter minus minimum stent diameter) divided by maximum stent diameter]. RESULTS: The Max SD was (3.45 ± 0.62 vs 3.55 ± 0.56 vs 2.97 ± 0.59) by IVUS vs SB vs QCA respectively. Max SD was significantly higher by IVUS vs QCA (p .009) and between SB vs QCA (p .001) while there was nonsignificant difference between IVUS vs SB (p .53). The Min SD was (2.77 ± 0.53 vs 2.58 ± 0.56 vs 1.88 ± 0.60) by IVUS vs SB vs QCA respectively. Min SD was significantly higher by IVUS vs QCA (p .001) and between SB vs QCA (p .001) while there was nonsignificant difference between IVUS vs SB (p .07). The stent symmetry index was (0.24 ±0.09 vs 0.34 ± 0.09 vs 0.14 ±0.27) by IVUS vs SB vs QCA respectively. It was significantly higher by IVUS vs QCA (p .001) and between SB vs QCA (p .001) while there was nonsignificant difference between IVUS vs SB (p .32). SB was positively correlated with IVUS measurements of Max SD (p < .0001 & r 0.74) and Min SD (p < .0001 & r 0.68). QCA was positively correlated with IVUS measurements of Max SD correlation (p < .0001 & r 0.69) and Min SD (p < .0001 & r 0.63). QCA was positively correlated with SB measurements of Max SD (p < .0001 & r 0.61) and Min SD (p .003 & r 0.49). CONCLUSIONS: StentBoost enhancement has superior correlations for stent expansion measured by IVUS when compared with QCA. SB enhancement improved stent visualization and identification of stent underexpansion to guide stent postdilatation.

Role of microRNAs -29b-2, -155, -197 and -205 as diagnostic biomarkers in serum of breast cancer females.

Micro-RNAs (miRs) are known to be differentially expressed in the serum of cancer patients and controls, and can thus be used as biomarkers for cancer screening. We detected the expression level of miR-29b-2, 155, 197 and 205 in the serum of female breast cancer patients and healthy controls to detect whether serum level of this chosen micro-RNAs could detect patients with breast cancer and also to detect difference in level of micro-RNAs between non-metastatic cases and metastatic cases, also we tried to detect any relation between level of micro-RNAs and the stage of the tumor, the size of tumor, nodal affection, the presence of metastasis and also the site of metastasis. Serum samples were collected from 130 female patients, 80 with non-metastatic breast cancer, 20 with metastatic breast cancer and 30 healthy controls. Real-time quantitative PCR was used to detect the expression level of miR-29b-2, -155, -197 and -205. The expression level of miR-29b-2, -155, -197 and -205 was significantly increased in the serum of breast cancer patients. miR-29b-2, -155, -197 and -205 may be useful as a blood-based biomarker for breast cancer screening.

Effects of carnosine on bilharzial infestation in hamsters: biochemical and histochemical studies.

We tested the ability of carnosine to improve some liver disorders induced by Schistosoma mansoni parasite in hamsters (Mesocricetus auratus). Results indicate that parasitic infestation induced elevation in serum alkaline phosphatase, gamma-glutamyl transferase, aspartate aminotransferase and procollagen III peptide as a marker of liver fibrosis. Administration of carnosine (10 mg/day) for 15 days either concurrent with infection, 2 and 4 weeks post-infestation was effective in reducing differential worm burden. It was also effective in renormalizing blood glucose level depending on the time course. The most evident effect of carnosine was on serum procollagen III peptide level, which was lowered in infested groups treated with carnosine. Histopathological studies confirmed the potential use of carnosine for intervention in schistosomiasis.

Angiotensin-converting enzyme I/D gene polymorphism affects early cardiac response to professional training in young footballers.

BACKGROUND: The renin-angiotensin-aldosterone system plays a role in physiological and pathological responses of the heart to both static and dynamic exercise. Previous studies showed that the level of angiotensin II is determined by the angiotensin-converting enzyme insertion/deletion (ACE I/D) polymorphism. AIM: We aimed in this study to determine the effect of ACE I/D gene polymorphism on the extent of functional and structural cardiac changes in response to one year of professional football training in young footballers. METHODS AND RESULTS: We studied 68 young male football players and a comparable control group. Besides medical history and clinical examination, 12 lead ECG and transthoracic 2D echocardiography examination were performed. Genotyping of ACE was analyzed using PCR-based technique. There was no statistically significant difference in distribution of genotypes among athletes compared with control subjects. D allele showed a graded effect on both EF (73.55, 67.5 and 60.2%, p=0.03) and PASP (37.6, 26.1 and 21.39 mmHg, p=0.02) in DD, ID and II subjects, respectively. CONCLUSION: Early cardiac changes in young footballers can be affected by ACE I/D polymorphism. There is a summative effect of the D allele in increasing EF and PASP in response to professional football training.

A polymorphism in the microsomal triglyceride transfer protein can predict the response to antiviral therapy in Egyptian patients with chronic hepatitis C virus genotype 4 infection.

BACKGROUND/AIMS: A polymorphism in the microsomal triglyceride transfer protein (MTP) is associated with hepatic fibrosis, and carriers showed higher levels of steatosis, higher levels of hepatitis C virus (HCV) RNA and advanced fibrosis. The aim of this study was to study MTP expression pattern in HCV patients and impact of the MTP polymorphism on the response to antiviral therapy. METHODS: One hundred consecutive naive HCV genotype 4 patients were recruited to receive antiviral therapy, and 40 control subjects were also recruited. Demographic, laboratory, and histopathology data were collected. DNA was isolated, and the samples were subjected to polymerase chain reaction analysis and genotyping for MTP by restriction fragment length polymorphism analysis. RESULTS: Patients and controls were age- and sex-matched (male/female, 56/44, age, 39.2±7.8 years for patients with HCV; male/female, 18/22, age, 38.1±8.1 years for controls). MTP single nucleotide polymorphisms (SNPs) (GG, GT, TT) and alleles (G, T) in the patients versus the controls were 70%, 21%, 9% & 80.5%, 19.5% versus 10%, 87.5%, 2.5% & 53.8%, 46.3%, respectively (p=0.0001). The sustained viral response (SVR) of the patients was 60%. SNPs in MTP genotypes (GG, GT, and TT) and alleles (G and T) in the responders and nonresponders were 71.7%, 25%, 3.3% & 84.2%, 15.8% versus 67.5%, 15%, 17.5% & 75%, 25% (p=0.038 and p=0.109, respectively). A multivariate analysis showed that the GT genotype was an independent predictor of SVR (area under the curve 90% and p=0.0001). CONCLUSIONS: MTP could be a new predictor for SVR to antiviral therapy in patients with HCV genotype 4 infection.

Radial approach and single wiring as first intentional strategies in chronic total occlusions of the left anterior descending coronary artery.

BACKGROUND: Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) of the left anterior descending coronary artery (LAD) specifically is associated with improved long-term 5 years survival as compared to PCI failure. Simpler PCI techniques may be successful and safer than complex techniques which are perceived to have high failure rates and technical complexity. We aimed to describe the safety and effectiveness of first intentional single wiring and radial approach in the treatment of patients with a CTO of the native LAD coronary artery at Toulouse Rangueil university hospitals. PATIENTS AND METHODS: The study was a single center prospective registry. All patients showed evidence of myocardial viability in LAD territory. The operators' initial strategy was to start by a radial access as a first choice whenever feasible; if not, a femoral access was chosen. The initial strategy for lesion crossing in either antegrade or retrograde approaches was single wiring by lesion crossing using one guidewire (GW) as a simple technique. RESULTS: A total of 30 patients with 30 LAD CTO lesions (100%) were recorded. Mean age was 71.6 + 15 years, 77% were males and 23% were females. The access route was radial 66% of the time and femoral 54% of the time and with double access for contralateral injection in 40% of the patients. Sheaths and catheters sizes 6F were used in 53% of the patients, and 7F in 73% of the patients. Overall lesion success rate was 83% of lesions. Single wiring was the prevailing technique used in 97% of successful lesions (83% of total cases), while only 3% were by multiple wiring techniques. Successful single antegrade wiring represented 63% of our total study cases with a GW success rate of 92% of cases. Successful single retrograde wiring represented 13% of our cases with a GW success rate of 67%. Q-wave myocardial infarction (MI), stent thrombosis, stroke, emergency coronary artery bypass graft (CABG), major bleeding, radiation dermatitis, cardiac tamponade or clinical perforation requiring any hemostatic maneuvers did not occur. There was a post-procedural Troponin rise of 3x normal levels in 30% of patients, and contrast induced nephropathy in 7%. Intra-aortic balloon counterpulsation (IABCP) was used in 3% of patients and cardiac death occurred in 3% of patients. CONCLUSION: Single wiring and radial access as initial strategies in PCI for LAD-CTO lesions in either approaches antegrade or retrograde are associated with a high procedural success rate and an acceptable incidences of adverse events.

Guidewires used in first intentional single wiring strategy for chronic total occlusions of the left anterior descending coronary artery.

BACKGROUND: Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) of the left anterior descending (LAD) specifically is associated with improved long-term 5 year survival as compared to PCI failure. The procedure is associated with usage of different types of dedicated guidewires by simple or complex techniques aiming to reopen the occluded artery. AIM: To describe types and outcome of guidewires used in LAD-CTO utilizing a first intentional single wiring simple strategy. METHODS: A single center prospective registry for all consecutive patients with a PCI attempt to a native LAD CTO. The initial strategy for lesion crossing was Single wiring. RESULTS: A total of 30 patients with LAD CTO lesions (100%), were recorded. Mean age was 71.6 + 15 years, 77% were Males, risk factors Hypertension in 63%, Diabetes 27%, Dyslipidemia 57%, smoking 40%, hereditary in 13% of patients. Isolated guidewire (GW) success rate was very high 93%. Single wiring was the prevailing technique used in 97% of successfull lesions (83% of total cases) while only 3% were by multiple wiring techniques. Successful single antegrade wiring represented 63% with a GW success rate of 92% of cases. Successful single retrograde wiring represented 13% with a GW success rate of 67%. Successful Crossing GW types in our patients were 44% Soft Tapered GWs; fielder XT (44%), 36% were Soft Non Tapered Pilot 50 (28%), whisper (8%), while 16% were Stiff Non tapered GWs; Miracle 12 (8%), Miracle 6 (4%), Miracle 3 (4%), and 4% were Stiff Tapered GWs; Progress 200 (4%). CONCLUSIONS: Single wiring as an initial strategy in PCI for LAD-CTO lesions has a high success rate and is associated with a 44% majority of Soft Tapered GWs, 36% Soft Non Tapered, 16% Stiff Non tapered GWs, and 4% Stiff Tapered GWs.