Your most important setting is Mesh. It's the draw distance. Put that on High or even Ultra with everything else on low. Then bring other settings up until your hitting the minimum fps you can deal with. I'd say 45 absolute minimum for me, wouldn't hack any lower anymore.
I found that using Afterburners frame rate limiter @59 and any FPS gave me horrific tearing. Just let my 580 fly free now
I found 62 fps worked for me, anything else resulted in visible tearing