BACKGROUND: Psychological stress is known to have a negative effect on the health and well-being of coronary artery disease (CAD) patients. Although the study of stress CAD samples has received considerable attention, few studies have examined the effects of gender and age, had multiple follow-ups over an extended period, and had extensive baseline assessment batteries. PURPOSE: In this study, demographic, clinical, social, and personality variables were evaluated as predictors of nine repeated assessments of stress over a 2-year period in 322 CAD patients (33.2% female). METHODS: At baseline, perceived social support, coping style, and social conflict were associated with stress ratings. Mixed models were used to evaluate predictors of reported stress during the subsequent 2 years. RESULTS: The results showed that higher stress was present in patients who were female and young. Follow-up stress was also found in patients with moderate income, congestive heart failure, high social conflict, low social support, and negative coping style. CONCLUSIONS: These findings may help clinicians identify patients who are likely to experience higher levels of stress over a prolonged period following a diagnosis of CAD and may also suggest which patients may benefit most from stress reduction interventions.