ABC | Volume 113, Nº2, August 2019

Original Article Lima et al The VICTIM register- Intra-hospital counseling Arq Bras Cardiol. 2019; 113(2):260-269 In both public and private services, the most prevalent guidelines had restrictive characteristics. The most prevalent were salt and salty food restriction, and fat and fried food limitations (50.3% vs. 70.3%, p = 0.064, respectively), as can be seen in Figure 1. Relationship between self-reported, intra-hospital nutritional counseling and nutritional knowledge Among the patients who received counseling, the nutritional knowledge was higher in the private service when compared to the SUS patients. However, among the non‑counselled patients, no differences were observed in the level of nutritional knowledge between the SUS and private health services (Table 4). Discussion The main finding of this investigation was the underutilization of in-hospital nutritional counseling for patients with STEMI, both in the private service and, especially, in the public service. In the SUS hospital, documentation of nutritional counseling was practically non-existent in the patient records. This finding is of concern, because the change in dietary habits is a class one recommendation for the post-AMI patient, and if it is encouraged in the in-hospital setting, there is an increase of adherence to this therapy, due the recent coronary event. 9,16,17,19,20,26 In the ideal setting, nutritional counseling should continue to be offered, even after hospital discharge, because it would enhance the work initiated in that environment. Table 2 – Clinical characteristics of the patients with STEMI receiving care at hospitals in Sergipe, based on the type of service (Public vs. Private) Variables Total (188) Public (151) Private (37) p value SBP, mm Hg* 140 (128-160) 140 (128-160) 140 (123-160) 0.909 # DBP, mm Hg† 86 (80-92) 84 (79-92) 90 (79-96) 0.190 # HR, beats/min‡ 85 (72-98) 85 (72-97) 80 (68-100) 0.849 # GRACE Score 136 (119-157) 135 (119-155) 142 (117-168) 0.228 # GRACE Score, n (%) <140 (low risk) 98 (55.1) 81 (57.0) 17 (47.2) 0.349 ** ≥ 140 (high risk) 80 (44.9) 61 (43.0) 19 (52.8) Killip, n (%) I 169 (90.4) 139 (92.1) 30 (83.3) 0.108 ** II 12 (6.4) 9 (6.0) 3 (8.3) III 5 (2.7) 3 (2.0) 2 (5.6) IV 1 (0.5) 0 (0.0) 1 (2.8) Cardiovascular risk factors, n (%) Family history of early CAD § 70 (37.2) 53 (35.1) 17 (45.9) 0.256 ** Systemic Arterial Hypertension 129 (68.6) 103 (68.2) 26 (70.3) 1.000 ** Dyslipidemia 76 (40.4) 57 (37.7) 19 (51.4) 0.139 ** Diabetes Mellitus 60 (31.9) 48 (31.8) 12 (32.4) 1.000 ** Smoking 58 (30.9) 53 (35.1) 5 (13.5) 0.010 ** Clinical history, n (%) Previous PVD // 20 (10.6) 17 (11.3) 3 (8.1) 0.769 †† Previous myocardial infarction 12 (6.4) 6 (4.0) 6 (16.2) 0.015 ** Cardiac insufficiency 7 (3.7) 6 (4.0) 1 (2.7) 1.000 †† Previous PCI ¶ 10 (5.3) 5 (3.3) 5 (13.5) 0.027 ** Nutritional Diagnosis, n (%) Low weight 3 (1.6) 2 (1.5) 1 (2.9) 0.171 ** Eutrophic 64 (37.6) 53 (39.3) 11 (31.4) Overweight 70 (41.2) 58 (43.0) 12 (34.3) Obesity 33 (19.4) 22 (16.3) 11 (31.4) (*) SBP: systolic blood pressure; (†) DBP: diastolic blood pressure; (‡) HR: heart rate; (§) CAD: coronary artery disease; (//) PVD: peripheral vascular disease; (¶) PCI: percutaneous coronary intervention; (#) Mann-Whitney test; (**) Chi-square test; (††) Fisher's exact test. 263