Triglyceride has not traditionally been considered the cornerstone of lipid risk factors for coronary artery disease. Yet emerging evidence from epidemiologic, clinical, cellular, genetic, and molecular studies suggests otherwise, namely, that levels of triglyceride and triglyceride-rich lipoproteins such as very-low-density lipoprotein (VLDL) are indeed independent risk factors for coronary artery disease. Further, triglyceride metabolism is associated with atherogenesis, and diminishing triglyceride levels is pivotal in decreasing the incidence of coronary artery disease, particularly in early-evolving atherosclerotic lesions.