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As aging populations grow and lifestyle changes, the incidence of CAD is escalating. Traditional biomarkers for CAD diagnosis, such as creatine kinase-muscle brain (CK-MB), troponins, and n-terminal pro b-type natriuretic peptide (NT-proBNP), are influenced by age, sex, the presence of chest pain, and renal function levels. However, since these biomarkers are also detected in many other diseases such as heart failure, chronic renal failure, pulmonary embolism, or septic shock, explore and identification of novel unique biomarkers for CAD are of clinical significance. Exosomes containing non-coding RNAs, proteins, and lipids can serve as biomarkers and regulators for regulate various biological processes. Exosomal non-coding RNAs have been identified as risk factors for CAD and pivotal elements in cellular functions, making them significant candidates for CAD diagnosis and prognosis. This review elaborates on the current understandings of CAD, highlights the important roles of exosomal non-coding RNAs in CAD diagnosis and treatment, and concludes with future perspectives.<\/jats:p>","DOI":"10.7717\/peerj.19352","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T08:42:34Z","timestamp":1749544954000},"page":"e19352","source":"Crossref","is-referenced-by-count":0,"title":["Exosomal non-coding RNAs: key molecules in the diagnosis and treatment of coronary artery disease"],"prefix":"10.7717","volume":"13","author":[{"given":"Cuixue","family":"Ma","sequence":"first","affiliation":[{"name":"Guangdong Provincial Engineering Technology Research Center for Molecular Diagnosis and Innovative Drugs Translation of Cardiopulmonary Vascular Diseases, University Joint Laboratory of Guangdong Province and Macao Region on Molecular Targets and Intervene, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China"},{"name":"Laboratory of 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