In the course of development of factor Xa (FXa) inhibitors, we have found unique compounds containing an N,O-and an N,N-spiro acetal structure. It appeared that the difference in overall conformation due to the N,Xspiro acetal structure might be important for FXa inhibitory activity. Therefore, other N,X-spiro acetal structures, an N,S-and an N,SO 2 -spiro acetal, were developed as analogues of the N,X-spiro acetal structure. Compound 7b (N,S-spiro acetal structure) was found to have the strongest activity in these series of N,X-spiro acetal compounds, which had ever been synthesized.
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