I finally got WoW working the way I want it. Rock solid 60 fps. First thing I did was enable the DirectX 11 code path by adding the line "SET gxApi "d3d11" to the config.wtf file.
This moved my frame rates up into the low to mid 50s. However, there were still sharp drops into the 40s, creating stuttering. I finally stopped being so stubborn and moved the slider from Ultra to High. Suddenly frame rates were a steady 60 fps. I further played around with the settings and increased some back to Ultra and still rock solid. Image quality is indistinguishable from what I had before. Have 8X AS and 4X AA as well.
My guess is that there is one graphical setting (that I haven't found yet - shadows maybe?) that is taxing my system too much if put at the highest setting at 1080p. I haven't found what it is but I don't care anymore. The game is finally running and looking great.
Yes, it is definitely shadows. Try setting everything to Ultra, then bring the shadow slider down 1 notch. There's only a slight visual difference between this and putting the slider up to ultra, you probably wont notice it.
These are the settings I use, which gives me 60fps in the vast majority of the game. Cities bring it down of course.
I also have a GTX 460 1Gb. If you feel like tweaking it a bit more, try enabling 16xCSAA and multisample Transparancy AA from the nvidia control panel.
This is done by setting AA to 16xQ and transparancy to multisample. If you want, you can even set transparancy to supersample, but this brings a very large performance hit. Looks nice though.
IMO, this gives better image quality than 4xMSAA (which is the setting I used to use) with about the same performance hit.
My res is only 1680x1050 though, so you may get more of a performance hit running at 1080p.
Does anyone know if ambient occlusion works with WoW?