I bought a 7 series are card for the 4k support. I don't know for 100%, but the 6 series wasn't supposed to support that resolution. However, a driver change may have gotten around that. So your YMMV with that card.
That having been said, I've noticed some weirdness on 4k display too. It's been a while since I messed with things, but you might try disabling the v-sync in the drivers/nvidia control panel. I know I had to do that for AAE because of the 30hz refresh rate, but I think disabling it in MAME works as you would expect (which you already tried).
I have everything torn apart as I'm actually starting my build. But, If I get some time in the next few days I'll see if I can fire things up and take a look at my performance and see if I can offer anything more to help you out.
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Re: Inconsistent MAME 153 performance issue with 4K display
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