Constant crashing and low performance spikes on high end pc

I have constant crashing and stuttering, specially annoying when I go to 5 ways and poe stops responding due to cpu spikes. Usually happens with shaders load

Computer specs:

- CPU: 9800x3d
- GPU: 5090 ti msi
- RAM: 36gb 6000 MT/s

Game Settings:
- Renderer: Tried all, when using dx12 or vulkan I crash on login, currently using dx11
- Triple Buffering: Enabled
- Multithreading: Enabled
- Antialiasing: Off
- Upscale: NIS(Default)
- Lightning: Shadows(Default)
- Sun Shadow Quality: Low
- Number of Lights: Medium
- Depth: Disabled
- Water: High
- Texture: High
- Texture Filter: Trilinear
- Dynamic Culling: Disabled
- Target Framerate: 60
- Vsync; Off
- Foreground FPS: 60
- Background FPS: 60
- Resolution: 4k

Thanks.