Weber D, et al. - Using two prospective cohorts of cardiac resynchronization therapy (CRT)-D patients with primary prevention indication and Fine and Gray models, researchers constructed predictive models and scoring systems to predict time to first implantable cardioverter–defibrillator (ICD) therapy and death without ICD therapy (prior death). The event of interest was time to first ICD therapy and competing event was death without prior ICD therapy. A high probability of ICD therapy combined with moderate/low probability of prior death defined CRT-D benefit. Overall 720 patients, followed for a median duration of 7.2 years, were included. The factors that predicted ICD therapy (but not prior death) in multivariable models included higher New York Heart Association classes, diuretic use, and ischemic cardiomyopathy. A higher risk for prior death was observed among males with comorbidities (cancer, renal failure, peripheral artery disease, body mass index >30) or systolic blood pressure ≤100. In association with higher age, a lower risk of ICD therapy but higher risk of prior death were reported. Overall, the detection of patients with a predicted low benefit of CRT-D (low chance of ICD therapy, high chance of prior death) was enabled by scoring.