摘要ObjectiveVery early-onset coronary artery disease (CAD) is a great challengein cardiovascular medicine throughout the world, especially regarding its early diagnosis. This study explored whether circulating microRNAs (miRNAs) could be used as potential biomarkers for patients with very early-onset CAD. MethodsWe performed an initial screening of miRNA expression using RNA isolated from 20 patients with angiographically documented very early-onset CAD and 20 age- and sex-matched normal controls. For further confirmation, we prospectively examined the miRNAs selected from 40 patientswithvery early-onset CAD and 40 angiography-normal controls. ResultsA total of 22 overexpressed miRNAs and 22 underexpressed miRNAs were detected in the initial screening. RT-qPCR analysisof the miRNAs obtained from the initial screening revealed that four miRNAs including miR-196-5p, miR-3163-3p, miR-145-3p, and miR-190a-5p exhibited significantly decreased expression in patients compared with that in controls (P<0.05).The areas under the receiver operating characteristic curve for these miRNAs were 0.824 (95% CI, 0.731-0.917;P<0.001), 0.758 (95%CI, 0.651-0.864;P<0.001), 0.753 (95% CI, 0.643-0.863;P<0.001), and 0.782 (95% CI, 0.680-0.884;P<0.001), respectively, in the validation set. ConclusionTo our knowledge, this isan advanced study to report about four serum miRNAs (miR-196-5p, miR-3163-3p, miR-145-3p, and miR-190a-5p) that could be used as novel biomarkers for the diagnosis of very early-onset CAD.