Men were more likely to benefit from the intervention.668,669 In another study, 123 patients who met the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, criteria for major or minor depression within 1 year of CABG were randomly assigned to 12 weeks of cognitive behavior therapy, 12 weeks of supportive stress management, or usual care.667 Both interventions were efficacious for treating depression after CABG, and cognitive behavior therapy had the most durable effects on depression and several secondary psychological outcome variables.667 Thus, both collaborative intervention and cognitive behavior ther- apy are effective for treating depression in patients after CABG. Given that depression is associated with adverse outcomes after CABG, it is likely that these interventions also may lead to reduced rates of morbidity and mortality. 4.9. Cardiac Rehabilitation: Recommendation Class I 1. Cardiac rehabilitation is recommended for all eligi- ble patients after CABG.679 681,681a 681d (Level of Evidence: A) See Online Data Supplement 29 for additional data on cardiac rehabilitation. Cardiac rehabilitation, including early ambulation during hospitalization, outpatient prescriptive exercise training, and education, reduces risk of death in survivors of MI.682 684 Beginning 4 to 8 weeks after CABG, 3-times-weekly educa- tion and exercise sessions for 3 months are associated with a Hillis et al 2011 ACCF/AHA CABG Guideline e683 35% increase in exercise tolerance (P 0.0001), a slight (2%) (P 0.05) increase in high-density lipoprotein cholesterol, and a 6% reduction in body fat (P 0.002).421 Exercise training is a valuable adjunct to dietary modification of fat and total caloric intake in maximizing the reduction of body fat while minimizing the reduction of lean body mass. 