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Symptoms of depression are often seen in patients with coronary heart disease. Symptoms appear more commonly in women and are negatively associated with measures of cardiovascular health. Using multiple logistic regression analyses, the authors evaluated the independent effects of depression (as measured by the Beck Depression Inventory [BDI-II]) and sex on cardiac rehabilitation (CR) completion. In addition, in those who completed CR, the authors evaluated whether depressive symptoms and sex affected clinical outcomes. Women as well as participants with enrollment BDI-II scores ≥14 had significantly higher rates of CR noncompletion. Patients with BDI-II scores ≥14 who completed CR achieved significant improvements in lipid profile, body mass index, and exercise capacity regardless of sex. Women and individuals with BDI-II scores ≥14 are at risk for CR noncompletion and should be encouraged to complete CR, because cardiovascular benefits comparable to those seen in men and individuals with low BDI-II scores were achieved when these patients completed the CR program.