Yeah, I'm using stock cooler. I'd consider buying another one but the stock cooler seems to be holding out ok for now.
I know some graphics card run hit 90+ under extreme load but I don't know whether that's ok really.
I think my airflow is decent enough, front and rear 120mm fans. My spec is:
Asus M4A87TD/USB3 870
AMD Phenom II X4 955 @3.6GHz
Sapphire Radeon HD 5770 1GB
4GB Corsair CL9 XMS3 RAM @1500MHz
500GB Samsung SpinPoint F3
Samsung SH-S223 22x DVD±RW
Coolermaster eXtreme Power 460W PSU
Coolermaster Elite 330 CaseHere's a pic