A Study to Test Whether Vicadrostat (BI 690517) in Combination With Empagliflozin Helps People With Heart Failure and a Weak Pumping Function of the Left Side of the Heart

Inclusion criteria:

1. At least 18 years old and at least at the legal age of consent in countries where itis greater than 18 years

2. Signed and dated written informed consent in accordance with International Councilfor Harmonisation of Technical Requirements for Pharmaceuticals for Human Use - GoodClinical Practice (ICH-GCP) and local legislation prior to admission to the trial

3. Male or female participants. Women of childbearing potential (WOCBP) must be readyand able to use highly effective methods of birth control per ICH M3 (R2) thatresult in a low failure rate of less than 1% per year when used consistently andcorrectly. A list of contraception methods meeting these criteria and instructionson the duration of their use is provided in the protocol.

4. Chronic heart failure (HF) diagnosed at least 3 months before Visit 1, and in NewYork Heart Association (NYHA) classes II to IV at Visit 1, with left ventricularejection fraction (LVEF) < 40% per local reading (obtained by echocardiography,radionuclide ventriculography, invasive angiography, magnetic resonance imaging (MRI), or computed tomography (CT)).

5. Elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) at Visit 1, analysedat the central laboratory

6. Treated according to best possible standard of care (SOC) (disregardingsodium-dependent glucose co-transporter 2 inhibitor (SGLT2i) and mineralocorticoidreceptor antagonist (MRA)) in accordance with applicable heart failure (HF)local/international guidelines and judgement of the investigator.

Additional inclusion criteria apply.

Exclusion criteria:

1. Treatment with an MRA (e.g. spironolactone, eplerenone, finerenone) within 14 daysprior to Visit 1 or requiring such treatment before randomisation or planned duringthe trial based on the judgment of the investigator. Treatment with an MRA shouldnot be discontinued with the intention of study enrolment.

2. Treatment with amiloride or other potassium-sparing diuretic within 14 days prior toVisit 1 or requiring such treatment before randomisation or planned during the trialbased on the judgment of the investigator.

3. Receiving the following treatments:

• A direct renin inhibitor (e.g. aliskiren) at Visit 2

• More than one angiotensin-converting enzyme inhibitor (ACEi), angiotensinreceptor blocker (ARB) or angiotensin receptor-neprilysin inhibitor (ARNi) usedsimultaneously at Visit 2

• Other aldosterone synthase inhibitors, e.g. baxdrostat at Visit 2 or plannedduring the trial

• Systemic mineralocorticoid replacement therapy (e.g. fludrocortisone) at Visit 2

• In case of acute decompensated HF:

• i.v. inotrope, i.v. vasodilating drug (e.g. nitrate, nitroprusside), ori.v. natriuretic peptide (e.g. nesiritide, carperitide), or mechanicalsupport (e.g. intra-aortic balloon pump, endotracheal intubation,mechanical ventilation, any ventricular assist device) within 24 hoursprior to randomisation

• i.v. diuretic with a dose that has been increased/intensified within 6hours prior to randomisation (a stable dose of an i.v. diuretic is notexclusionary)

4. Myocardial infarction (MI), transient ischemic attack (TIA), stroke, coronary arterybypass graft surgery (CABG), heart valve surgery/intervention or any other majorsurgery (major according to the investigator's assessment) within 90 days prior toVisit 2, or scheduled for major elective surgery (e.g. hip replacement, CABG)

5. Percutaneous coronary intervention (PCI) or any angiography using iodinated contrastagents in the 7 days prior to Visit 2

6. Heart transplant recipient, awaiting heart transplant, or currently implanted leftventricular assist device (LVAD)

7. Known cardiomyopathy based on infiltrative diseases (e.g. amyloidosis), accumulationdiseases (e.g. haemochromatosis, Fabry disease), muscular dystrophies, hypertrophicobstructive cardiomyopathy or known pericardial constriction, or cardiomyopathy withpotentially reversible cause such as stress or peripartum cardiomyopathy orcardiomyopathy induced by chemotherapy within 12 months prior to Visit 1 and untilVisit 2

8. Acute inflammatory heart disease, such as acute myocarditis, within 90 dayspreceding prior to Visit 1 and until Visit 2 Further exclusion criteria apply.