A risk score to predict the absence of left ventricular reverse remodeling: Implications for the timing of ICD implantation in primary prevention.

•The achievement of target doses in heart failure (HF) with reduced ejection fraction is feasible in most patients.•50% of patients achieve left ventricular reverse remodeling after HF therapy optimization.•50% of patients lose the potential implantable cardioverter defibrillator (ICD) indication after HF therapy optimization.•The proposed risk score may help to decide the timing of ICD implantation.•The use of a wearable-ICD may prevent mortality during HF therapy optimization.