I have had this card for some time now and overall this is a good choice for if you are simply looking to play games, personally I have played Oblivion, X3:reunion, Farcry and Sims 2 to name but a few on their respective highest settings without any problems.
Installation of the card was easy enough, although i would note that due to the size of the card some of the smaller PC cases may have difficulty housing it. It also extends across one of the other card slots in my computer so if space and PCI scots are critical i would suggest a more compact card.
The card also comes pre-optimised and the application supplied with it can be used to alter the settings for the core and memory clocks easily with just a few clocks, the fan speeds are also directly controllable allowing for further optimisation should this be desired.
Noise wise the card doesn't make any more noise than that of the PSU or processor fan and so unless you are trying for a silent build this would not be an issue.
However this all said there does appear to be some instability in the card if it is below a certain temperature that will prevent any of the latest openGL rendering to function and occasionally stop the Nvidia drivers loading. I have coped perfectly well with the card on many openGL games despite the design flaw, however if you want to do any 3dmodelling i would suggest that this is not the card for you.