Backgrounds: Relationship between coronary artery calcification (CAC) and increased aortic stiffness have been demonstrated in patients with coronary artery disease. However, little is known about the relationship between CAC and aortic stiffness, other parameters in patients with early atherosclerosis. We tested the hypotheses that independent relationship between CAC and aortic stiffness in patient with early atherosclerosis. Methods: Subjects with chest pain or positive non-invasive stress test were simultaneously evaluated by brachial ankle pulse wave velocity (baPWV) and multidetector computed tomography. Subjects with significant CAD (diameter stenosis >50%), diabetes, chronic renal insuffiency and taking anti-hypertensive medication within 1 week were excluded. The data of total 140 subjects (mean age 짹 SD: 53 짹 11 years, male vs. female: 44: 96) were finally analyzed. CAC score was quantified from multidetector computed tomography. Traditional risk factors, lipid profiles, hsCRP and metabolic parameters (fasting blood glucose, insulin) were analyzed. Results: CAC positive group (N=20, CAC score: 78.5짹227.8) showed old age (61.6짹10.6 vs. 51.8짹10.3 years, p<0.001), high systolic and diastolic blood pressure (134.4짹20.9 vs. 119.4짹15.2 mmHg, p=0.006, 78.8짹10.6 vs. 73.2짹11.0 mmHg, p=0.035), high fasting blood sugar (102.9짹9.2 vs. 93.5짹9.5 mg/dL, p<0.001), high HgA1c (5.98짹0.39 vs. 5.67짹0.69 %, p=0.065), high waist circumference (89.0짹9.6 vs. 84.7짹8.5 cm, p=0.04) and increased baPWV (1658.5짹300.9 vs. 1329.5짹202.2 cm/sec, p<0.001) compared with those of CAC negative group (N=120). There were no significant differences on gender, smoking history, alcohol consumption history, lipid profiles, hsCRP, serum creatinin. BaPWV (odd ratio 1.005, 95% CI 1.003-1.008, p<0.001) and fasting blood sugar (odd ratio 1.118,95% CI 1.033-1.210 p=0.006) were independent factor for the presence of coronary artery calcification by multiple logistic regression analysis. Conclusions: Increased aortic stiffness and fasting blood sugar are independent factor for the presence of coronary artery calcification in patients with early atherosclerosis. Therapeutic stratergy for improving aortic stiffness and metabolic parameters may prevent coronary artery calcification which is one of the major process of coronary atherosclerosis.