The purpose of this trial is to find out if a drug called empagliflozin, in addition to normal care, will reduce the risk of heart failure and death in patients who are hospitalized for acute MI.

Main Inclusion Criteria:
• Signed and dated written informed consent in accordance with ICH-GCP and local legislation prior to admission to the trial
• Diagnosis of acute MI (type 1 per the Universal Definition of Myocardial Infarction [R20-0005]): STEMI or NSTEMI with randomization to occur no later than 14 calendar days after hospital admission. For patients with an in-hospital MI as qualifying event, randomization must still occur within 14 days of hospital admission.

• High risk of HF, defined as EITHER
a) Symptoms (e.g. dyspnea; decreased exercise tolerance; fatigue), or signs of congestion (e.g. pulmonary rales, crackles or crepitations; elevated jugular venous pressure; congestion on chest X-ray), that require treatment (e.g. augmentation or initiation of oral diuretic therapy; i.v. diuretic therapy; i.v. vasoactive agent; mechanical intervention etc.) at any time during the hospitalization.

OR
b) Newly developed LVEF < 45% as measured by echocardiography, ventriculography, cardiac CT, MRI or radionuclide imaging during index hospitalization.

• In addition at least one of the following risk factors:
- Age > 65 years
- Newly developed LVEF < 35%
- Prior MI (before index MI) documented in medical records
- eGFR < 60 ml/min/1.73m2 (according to creatinine from most recent local lab during the index hospitalization and calculated with the CKD-EPI formula)
- Atrial fibrillation (persistent or permanent ; if paroxysmal, only valid if associated with index MI)
- Type 2 diabetes mellitus (prior or new diagnosis)
- NTproBNP >1,400 pg/mL for patients in sinus rhythm, >2,800 pg/mL if atrial fibrillation; BNP >350 pg/mL for patients in sinus rhythm, >700 pg/mL if atrial fibrillation, measured at any time during hospitalization
- Uric acid >7.5 mg/dL (>446 μmol/L), measured at any time during hospitalization
- Pulmonary Artery Systolic Pressure >40 mmHg (non-invasive [usually obtained from clinically indicated post-MI echocardiography] or invasive, at any time during hospitalization)
- Patient not revascularized (and no planned revascularization) for the index MI (Includes e.g. patients where no angiography is performed, unsuccessful revascularization attempts, diffuse atherosclerosis not amenable for intervention; but does NOT include if revascularization was not performed due to nonobstructive coronary arteries)
- 3-vessel coronary artery disease at time of index MI
- Diagnosis of peripheral artery disease (extracoronary vascular disease, e.g. lower extremity artery disease or carotid artery disease)

Main Exclusion Criteria:

• Diagnosis of chronic HF prior to index MI
• Systolic blood pressure < 90 mmHg at randomization

• Cardiogenic shock or use of i.v. inotropes in last 24 hours before randomisation
• Coronary Artery Bypass Grafting planned at time of randomisation
• Current diagnosis of Takotsubo cardiomyopathy
• Any current severe (stenotic or regurgitant) valvular heart disease
• eGFR < 20 ml/min/1.73m2 (using CKD-EPI formula based on most recent creatinine from local lab during hospitalisation) or on dialysis
• Type I diabetes mellitus
• History of ketoacidosis