Despite the advisory, controversy remains about which symptoms of depression are most important in cardiac patients. Studies6–8 have indicated that compared with cognitive/affective symptoms, somatic/affective symptoms are more predictive of health outcomes, including mortality, in cardiac patients. However, somatic indications are confounded by health status, which mediates their relationship with poor outcomes.6–8 In contrast, cognitive/affective symptoms may be underrecognized in cardiac patients because these symptoms are more subtle in these patients than in otherwise healthy, depressed persons.9 In addition, cognitive/affective symptoms—but not somatic/affective symptoms—have been associated with prolonged elevation of levles of C-reactive protein, a marker of generalized inflammation, which is in turn a hallmark of CHD.10 To date, no investigators have evaluated symptom clusters (defined as unique groups of 2 or more symptoms that occur together and are related11) of depression in hospitalized CHD patients.