Have you run any monitoring to check your memory usage and or temps? You may have some background processes eating up some memory or your gpu could be throttling due to temperatures.
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Temps are fine, and I can't find anything eating up a lot of memory
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Well, I would play with the gpu & fans settings. I’ve seen micro studdering happen from clock speeds fluctuating when getting into the low/mid 70’s. I have also had stuttering in other games caused from usb devices being plugged in (controller and external hdd).