The cause was a heart attack or stroke, HBO officials said. A Rome hospital confirmed that Gandolfini had been brought there for treatment.
The "Sopranos," recently named the best TV show of all time by the Writers Guild of America, ran on HBO from 1999 to 2007 and starred Gandolfini as barrel-chested New Jersey Mafia capo-turned-boss Tony Soprano.
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His character alternated acts of mayhem, infidelity and fierce family loyalty with anguished visits to his psychiatrist, Dr. Jennifer Melfi, portrayed by Lorraine Bracco. His regular haunt was the Bada Bing, a strip club that frequently served as a base for his underworld enterprises.
In Gandolfini's hands, a potentially unsympathetic and unrelatable character became a kind of post-modern Everyman, even down to his troubled relationship with suburban wife Carmela, played by Edie Falco.
He won three Emmy Awards for the role, now considered one of the landmark characters of television drama. By the early 1990s, he had experienced some success on Broadway but Tony Soprano made him a star.
"He was a genius," David Chase, the writer who created the show, said in a statement. "Anyone who saw him even in the smallest of his performances knows that. He is one of the greatest actors of this or any time. A great deal of that genius resided in those sad eyes. I remember telling him many times, 'You don't get it. You're like Mozart.' "
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The mob series, along with the comedy "Sex and the City," vaulted HBO from a pay-cable outlet for studio movies and boxing to a destination for original programming that dominated the cultural conversation. The premiere of the fourth season in 2002 drew 13.4 million total viewers, according to Nielsen — an enormous figure for a scripted show on a network that was available in fewer than one-third of U.S. households.
That success led to an explosion in original series for basic cable networks, a trend that continues with such Soprano-like antiheroes as tortured cop Vic Mackey (Michael Chiklis) on FX's "The Shield"; the ad man with the double life, Don Draper (Jon Hamm) on AMC's "Mad Men"; and vigilante serial killer Dexter Morgan (Michael C. Hall) on Showtime's "Dexter."
"The Sopranos" started a movement toward edgier programming on cable that ultimately led to sharp viewing declines for the major networks.
Gandolfini was born in Westwood, N.J., on Sept. 18, 1961, to working-class parents of Italian American stock. His father was a bricklayer who later became a high school custodian; his mother worked in a cafeteria at the same school.
His immigrant parents spoke Italian at home, but Gandolfini, one of three children, never learned the language although, he later told interviewers, he always understood when they were angry with him. He retained a strong sense of his Italian roots into adulthood, he later said.
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As the first-born male child of ambitious immigrants, he faced intense parental pressure to attend college, a notion he initially resisted. He earned a bachelor's degree in communications in 1983 from Rutgers University.
"My mother beat it into me, 'You're going, you're going,' " he later recalled. He finally relented and on his first night at Rutgers strolled into a keg party. "I thought, 'What was I fighting for?' " he later joked.
His ultimate choice of a profession was inspired by the 1970s films he grew up with, including "Mean Streets," Martin Scorsese's breakthrough feature about a young Mafia soldier Charlie (Harvey Keitel) torn between loyalty to local mob bosses and his troubled friend Johnny Boy (Robert De Niro).
"I saw that 10 times in a row.… I just sat there," Gandolfini recalled years later on Bravo's "Inside the Actors Studio." "I thought everything about it was great."
But success was slow in coming. During his mid-20s, he was persuaded by Roger Bart — a friend who later found fame in Broadway's "The Producers" — to attend an acting workshop emphasizing the Method acting techniques of Sanford Meisner, who encouraged students to use improvisation exercises to arrive at more immediate and emotional interpretations of characters.
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