Aim Postprandial hypertriglyceridemia is an independent risk factor for coronary heart disease and atherosclerosis.This study was designed to explore the effect of once 1000 u coenzyme A(CoA) injection or capsule on postprandial triglyceride level after a high-fat meal in Chinese patients with fasting hypertriglyceridemia. Methods Ten healthy controls and 20 patients with fasting hypertriglyceridemia took a baseline high-fat meal(800 calories,50 g fat) after diet direction.And blood samples were collected at 0,2,4 and 6 h after the baseline meal.On the second day,all patients accepted a high-fat meal again and randomly took 1000 u CoA orally at 30 min before the meal or by intravenous drip immediately after the meal within 1 h.Blood samples were also collected at 0,2,4 and 6 h after the second meal.Blood lipids levels were assayed and percentages of increment in postprandial triglyceride level at 2,4 and 6 h after the meal were calculated. Results The postprandial serum triglyceride levels increased significantly at 2,4,6 h in patients while only at 2 h in healthy controls(P<0.05).Postp-randial serum total cholesterol,high density lipoprotein cholesterol and low density lipoprotein cholesterol levels did not change significantly when compared with their fasting levels,respectively.Taking all patients accepting CoA capsule or injection as a total(n=20),a significant decrease was found in percentage of increment in postprandial triglyceride level at 6 h after CoA treatment(62.4%±13.1% vs 42.1%±9.2%,P<0.05).Subgroup analysis showed that both postprandial triglyceride level at 6 h(4.63±2.40 mmol/L vs 3.80±2.08 mmol/L,P<0.05) and percentage of increment in postprandial triglyceride level at 6 h(62.8%±17.7% vs 39.0%±14.9%,P<0.05) significantly decreased after CoA injection treatment.However,decreases of postprandial triglyceride level and percentage of increment in postprandial triglyceride level did not reach statistical significance in patients taking CoA capsule. Conclusion This small-sample study showed that once 1000 u CoA injection immediately after meal effectively lower postprandially increased serum triglyceride level at 6 h after a high-fat meal in patients with fasting hypertriglyceridemia while once 1000 u CoA capsule did not significantly decrease postprandial hypertriglyceridemia.