The first Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI) trial published in 1986 changed the therapeutic landscape of cardiology when it demonstrated the efficacy and safety of streptokinase in AMI. Tavazzi was closely involved in all five GISSI trials, including GISSI-2 (comparing the efficacy of streptokinase and alteplase), GISSI-3 (demonstrating the ACE-inhibitors can further improve survival after AMI), and GISSI Prevenzione (showing reduced mortality in patients with a previous AMI taking n-3 PUFA).
The GISSI trials, altogether involving more than 60,000 patients with AMI or heart failure, launched a tradition in cardiology of large-scale trials addressing important questions that were independent of the pharmaceutical industry. “The pioneers of GISSI – Fausto Rovelli and Gianni Tognoni - had the charisma and force to get the entire Italian cardiology community behind them without a single penny in their pockets,” remembers Tavazzi, a clinical cardiologist who has worked for the majority of his career at the University of Pavia.
The basic principle underlying GISSI, he explains, was that active participation produces change more effectively than a more passive lecture-room approach. Since Italian cardiologists were involved in the studies from the outset, they enthusiastically embraced GISSI's findings.
Trained in both internal medicine and intensive care at Pavia, Tavazzi was appointed director of the Intensive Coronary Care Unit at Pavia University Hospital in 1971, becoming involved in the developing area of electrophysiological investigations. “This was a great period in my life!” he recalls. “It was here I met my wife (the cardiologist Marina Ray). And here that some enthusiastic friends and I ‘invented’ routine invasive hemodynamic monitoring of patients with AMI, and continuous ECG recordings on paper of patients with unstable angina.”
In 1997 he was appointed Head of Cardiology at the University Hospital of Pavia, with interests now shifting from cardiac intensive care towards the more neglected area of chronic cardiac diseases.
Tavazzi was Chairperson of the Working Group on Cardiac Rehabilitation and Exercise Physiology of the ESC and on the Task Force which produced the first ESC Guidelines on Cardiac Rehabilitation. He is currently Chairperson of the ESC Working Group on Myocardial and Pericardial Diseases and of the ESC Committee of Surveys and Registries.
Never one to stand still, in September last year Tavazzi became scientific director of GVM Hospitals of Care and Research, a network of private hospitals located across Italy and other European countries. “I am building up a basic research institute, defining the lines of research we intend to pursue over the coming years and linking the organisation to international research networks,” he says, adamant that this will not affect his ongoing involvement with GISSI.