Atherosclerosis is a chronic disease characterized by the accumulation of lipids and fibrous elements in the large arteries, which is the principal cause of coronary artery disease. Dysregulated exosomal microRNA (miRNA) levels in serum have been identified in patients with various diseases, including CAD. In the present study, nine candidate miRNAs were detected in the plasma exosome from 42 patients with coronary atherosclerosis, and a higher expression of miR-30e and miR-92a was identified in patients. Following bioinformatics analysis and confirmation through immunoblotting, it was demonstrated that ATP binding cassette (ABC)A1 is a direct target of miR-30e, and miR-92a. Furthermore, a negative correlation was identified between plasma miR-30e and ABCA1, or miR-30e and cholesterol. Thus, the results of the present study suggest that the miR-30e level in exosomes from serum may have the potential to be a novel diagnostic biomarker for coronary atherosclerosis.