INS and heart failure: Heart failure risk reduction was also observed in a few other studies including Evans et al. (HR: 0.57; 95% CI: 0.35-0.92), Kunutsor et al. (pooled HR (95% CI) of 0.92 (0.84-1.00)) and Thein et al. in 2020, who found that the risk was increased in patients on insulin, though there was no significant difference among the various second-line agents used [23, 25-26].