Visually assessed coronary and cardiac calcium outperforms perfusion data during scintigraphy in the prediction of adverse outcomes

•Stress SPECT is used mainly to demonstrate reversible myocardial perfusion defects.•Coronary and cardiac calcium has been associated with worse prognosis.•In SPECT-CT, CT imaging data used for attenuation correction are usually discarded.•We enrolled 353 patients evaluating perfusion data and coronary and cardiac calcium.•A calcium score > 2 was the strongest predictor of death or myocardial infarction.