To characterize relations between coronary plaque formation, focal, "spotty" coronary calcified lesions, and luminal narrowing, coronary calcium was examined by electron-beam computed tomography in 49 patients with normal or near-normal angiograms. Based on a coronary segmental analysis and on a patient-by-patient analysis, spotty coronary calcium was associated with slight angiographic changes consistent with early atherosclerotic disease and compensatory arterial remodeling.