Patients with angiographic evidence of early coronary atherosclerosis (<50% diameter: stenosis) have a poorer prognosis than those with normal arteries and may benefit from more aggressive interventions targeted toward the primary prevention of cardiovascular disease. Using a calcium score of 5, fast computed tomography was able to identify 59% af patients with early atherosclerosis, while excluding 87% of patients with smooth, luminally normal coronary arteries.