I recently bought a 4870 and it runs at 42-46c when idle and up to 58c when playing crysis warhead on full settings, 4x anti-aliasing, v-sync on, 1280-1024(which is slightly higher than 1440x900) during 4 hours of game play can get alittle loud but stays very cool. I got this video card(link on the bottom of the reply). The game was bearly playable, but with a weak system also. E5200 processor (2.5ghz Dual-core(not core 2 duo) @ 800mhz bus speed, memory(2x2gb stock(came with computer)memory @ 800mhz And a mother boards that has a pci express x16 1.0 slot.
I would recommend the Sapphire 4870 1GB DDR5 version, I don't know what the prices are, but I've experienced the sapphire on my friends comp and that certainly was satisfying in regards to temperature and noise. I advise the 1GB version since it it will be beneficial if you are going to play higher resolutions and usually there is only a minimal price difference between the two.
Whichever one you get, make sure you`ve enough space around the card if you purchase one with a cooler that does n`t exhaust out of the case.
I have this thing about not dumping upwareds of 130W of extra heat into my case, so I`d say the IceQ or, if you don`t live somewhere hot, there`s nothing wrong with the reference cooler. Mine is set to 36% and stays below 74C, even under high stress games (although it will reach 83C running the Furmark stress test, but that`s a savage test).