This two-wave longitudinal study examines the ability of pessimistic attributional style and coping strategies to predict depressive symptoms in a sample of 99 patients with coronary heart disease (CHD). After the cardiac episode, the globality dimension of this style was associated with increased depressive symptoms, and this association was mediated by the low use of effective coping strategies. Stability and globality dimensions of pessimistic attributional style could also predict depressive symptoms eight weeks later. Cardiac intervention programmes should include the treatment of these symptoms and promote effective coping strategies as well as the modification of these stable and global attributions.