This article is more than 5 years old. Information may no longer be current.
A Conversation with Antonio Colombo, MD, FACC, FESC, FSCAI
In this issue, Dr. Bhatt talks with Antonio Colombo, MD, FACC, FESC, FSCAI, director of the invasive cardiology department at San Raffaele Scientific Institute and Columbus Hospital in Milan, Italy, and visiting professor of medicine at New York-Presbyterian Hospital, Columbia University Medical Center, New York.
Deepak L. Bhatt
Antonio Colombo
Colombo has performed landmark work in the field of coronary stenting and stent thrombosis and has received several distinctions, including the TCT Career Achievement Award and the PCR Ethica Award. He is on the editorial board of many major cardiology and interventional cardiology journals and has published more than 500 papers in peer-reviewed journals.
What are your hobbies outside of practicing medicine?
Dr. Colombo: I enjoyed skiing, but I gave it up 2 years ago. I find the slope has gotten too congested. Now, I enjoy going for long walks in the snow trails with my dog, which I find more relaxing than skiing. I appreciate good books, particularly about history, and movies. I also own a winery that my son operates full time. Over the past 4 to 5 years, I’ve made an attempt to develop a real knowledge about wine, so I’ve been reading a lot about wine making in addition to history.
Who has had the greatest influence on your career?
Dr. Colombo: Three people in particular. First is my father, who was very influential in giving me a moral attitude. His very simple statement of never postpone until tomorrow what you can do today has made a deep impact on me. He also said, “If you say something, put it in writing because it is much more important written down.” Another influence was Harold Olson, MD, who was the chief of the critical care unit at the V.A. Medical Center of Long Beach, Calif., when I was a fellow there. I really learned medicine and cardiology from him. And the third influential figure was Veeraf Sanjana, MD, a very knowledgeable individual, with an attitude that influenced me a great deal, specifically his emphasis on obtaining an appropriate diagnosis supported by evidence and leading to optimal patient care.
What has been the greatest challenge of your professional career thus far?
Dr. Colombo: The relationship with the academic milieu. The challenge I find in Italy and Europe, more so than in the United States, is that relationships with academia are less meritocratic and more political and social. So I’ve tried to stay away from this for the most part. I work in a university hospital and teach students and fellows, but I don’t have an academic title. I remember many years ago, I talked with the dean of the medical school and I reiterated my concerns. He said, “Don’t worry. You’re not a professor. You’re a maestro. The title is not very important.” So, I teach if I want to, and if I don’t, no one can get upset with me. Thankfully, all of the students recognize me and I get a lot of appreciation when I put on conferences. They all come. To me, this is much more rewarding than any title.
What advice would you offer a student in medical school today?
Dr. Colombo: People should be enthusiastic without any fear regarding difficulties. Progress comes from people who successfully broke current rules.
Have you ever been fortunate enough to witness or to have been part of medical history in the making?
Dr. Colombo: Many people aren’t recognized until after their deaths, so I consider myself very fortunate to witness the positive effects of my suggestions in my lifetime. The most important is the concept of dual antiplatelet therapy. This is not widely known, but at a recent meeting, Marco Valgimigli, MD, from Rotterdam, the Netherlands, recognized me as the first person to utilize DAPT. Before the concept of DAPT, thienopyridine, which was ticlopidine, was very little utilized. The idea to combine aspirin with ticlopidine was initially found very odd and not rational. When I spoke at meetings about combining these two drugs together the criticism was that it was like combining two beta-blockers. Little was known about P2Y12 receptor antagonists. The idea to use another antiplatelet agent was odd, but I felt that aspirin was not a completely effective antiplatelet agent alone. At that time, we were giving warfarin and heparin, so bleeding was a real problem. As a result, this changed the way we implant a coronary stent and helped to change the therapeutic approach in the post-stenting period. Also, the usage of IVUS to better check if the stent is well expanded was one of my ideas. So, thanks to a little bit of intuition and a lot of luck and persistence, I was fortunate to see these two suggestions work out in the end.