Reference cards USUALLY have a slot blower cooler that exhausts out the back. GREAT for small cases that don't get a lot of interior airflow... much like my mini ITX case and my reference design EVGA GTX670 FTW. Crysis 2 makes it run the hottest and it never gets over 70C, which I would call hot, and there is VERY LITTLE airflow in my case.
The slot cooler's real design is 2 fold, it exhausts hot air out the back of the case, thus reducing the amount extra heat pumped into the case, and that is DEFINITELY true in my Cooler Master EP120 ITX case. My CPU temps dropped 2C when I installed this over my GTX460 downdraft cooler
Second, with the video card butted right up against case side, it makes better use of the little air it gets. IE, 70C sounds hot, and sure, in a big ATX case it would probably run 65C. But its still very acceptable, and that's at 98% utilization, if I have VSYNC on and its only running like 50% load, its only like 58C.
My aftermarket cooled GTX 460 and 560Ti both ran about 76C in the same setup.
Dry