In Reply We thank Lavie and colleagues for their interest in the results of our recently published Comparison of Depression Interventions After Acute Coronary Syndrome (CODIACS) Vanguard trial,1 which showed that depressed patients with acute coronary syndrome (ACS) randomized to centralized, stepped, patient-preference depression treatment (psychotherapy or medication use) had substantially fewer depressive symptoms after 6 months compared with those receiving enhanced usual care. We also demonstrated that we could deliver this depression treatment by telephone and/or by webcast across a number of different health care settings in geographically diverse areas. These elements will be vital design components of a future phase 3 trial of depression treatment for patients with ACS.