In the ten years since their beginning, the GISSI studies have obtained wide recognition in the international world of cardiology and are considered a methodological landmark.

Besides their results on the efficacy of the experimental treatments, these studies have contributed knowledge on different aspects:

- Methodological and scientific aspects:

the GISSI studies, characterized by the wide participation of Italian Coronary Care Units (about 4/5 of those existing in the country) and by the adoption of protocols closely following clinical practice, have allowed the recruitment of large numbers of patients over short periods of time, ensuring not only a high statistical power but also the evaluation of the treatments' effects in real populations of patients with acute myocardial infarction, avoiding the artificial conditions of patient selection commonly shared by usual clinical experimentations. The creation of a permanent network of clinical monitors within Centres allowed to ensure a reliable and correct process of data collection.

- Reliable data on the epidemiology of relevant clinical events:

the availability of a very large database has not only allowed an evaluation of the incidence of the main clinical events which characterize the acute phase of AMI, such as mortality, but also to estimate time trends of clinically relevant events, in terms of incidence and prognosis (i.e.: ventricular fibrillation, reinfarction, stroke, etc.)

- Transfer of the results to clinical practice:

in general, transfer of the results of the scientific literature to clinical practice takes place very slowly. GISSI has accelerated this process: currently, the use of thrombolysis in patients with acute myocardial infarction is widespread (GISSI-3 data) and surely more common than that observed in CCUs in the USA and in Canada.

- Feasibility of quality control programs of instrumental and laboratory tests at national level:

in order to allow stratification of the risks of patients with myocardial infarction after hospital discharge, several instrumental tests (bidimensional echocardiography, holter, stress test) were collected. The centralised reading of a 10% random sample of such tests has shown a reasonable degree of accordance with the readings carried out locally. In GISSI Prevention quality control of laboratory tests is planned.