Aim To identify the correlation between microRNA (miRNA) and low-response to clopidogrel in patients with coronary heart disease (CHD), and explore their diagnostic value as biomarkers of low-response to clopidogrel.Methods 158 patients with stable CHD were recruited as the research population. The maximum platelet aggregation rate (MPAR) induced by adenosine diphosphate (ADP) was measured using light transmission aggregometry for all these patients. Eventually, 35 patients of them whose MPAR≥65% were allocated to low-response group. For comparison, 35 age-and gender-matched patients with MPAR＜65% were allocated to normal-response group. The peripheral blood mononuclear cells (PBMC) were isolated from the blood samples of each patient to extract total RNA. The expression differences of miR-34a-5p, miR-370-3p, miR-432-5p and miR-495-3p in the two groups were detected by real-time quantitative PCR. The diagnostic value of differently expressed miRNA for low-response to clopidogrel were evaluated by correlation analysis and receiver-operating characteristic (ROC) curve analysis. Results Compared with normal-response group, the expressions of miR-34a-5p and miR-495-3p were significantly elevated in low-response group, and their fold changes were greater than 2 (P＜0.05). There was no significant difference in miR-370-3p and miR-432-5p expressions between two groups (P＞0.05). The expressions of miR-34a-5p and miR-495-3p were positively correlated with MPAR in CHD patients (r＝0.709, P＜0.01; r＝0.597, P＜0.01). ROC curve analysis showed that the area under the curve(AUC) of miR-34a-5p was 0.789, and the AUC of miR-495-3p was 0.787; while the AUC of miR-34a-5p+miR-495-3p was 0.873, which was significantly higher than that of miR-34a-5p (P＜0.05) or miR-495-3p (P＜0.05). Conclusion Both the high expression of miR-34a-5p and miR-495-3p were associated with low-response to clopidogrel in CHD patients, and may serve as novel biomarkers for low-response to clopidogrel in CHD.