Vsynch with 60 fps/dynamic as others said, except in games that get input delay... I cant stand that so Ill take tearing over it
Ideally Im fine with 45+ fps, less than that it gets noticeably "slow"
When it comes to which options I disable, its funny you mention Ambient Occlusion because thats always my first choice... Heck, I disable it regardless of performance
Worst feature that has come out recently... It always creates these horrible fake looking shadows whenever two objects collide, its awful... Far Cry 3 was a particularly bad example of it, the characters even had black halos around them for no reason
Fortunately (or unfortunately, depending on your point of view) with most games nowadays, there is little difference between medium-high and max settings... You pretty much have to stop and stare at things to notice it, which is something you will never do while playing a fast paced game
So those of us with midrange cards can enjoy great performance with 90% of the quality
Im looking forward to see how this will change with the new consoles