I suddenly dont get over 65 FPS

PC Spec:
GPU: Nvidia RTX 4070
CPU: AMD Ryzen 5 7600X
RAM: 16GB DDR5 in a dual channel config.

Im using DX12 and every other graphic setting on the lowest possible setting.
Ive cleared my shader cache multiple times.
My Nvidia Control Panel has an FPS cap of 147 and my Monitor refresh rate is correctly set to 144Hz.

It started happening about 2 days ago it was fine the whole League before that.
The weird thing is only PoE seems to be the problem other Gakmes work completely fine.
I even drop below 40 fps when running non juiced Maps which wasnt the case until a couple days ago and frankly on my machine should rarely be the case at all.

Im at a loss here any help is greatly appreciated.