Turning texture quality down bellow your avalable VRAM won't gain any performance anyway....with everything set to low ingame (textures, render quality, view distance, shadow density, all right down).
It does occur to me though, Sobek, your not running with AA/AF/vsync or some other performance sapping setting turned on in the control panel are you?
Vsync doesn't effect performance aside from capping the max framerate at the refresh rate, that is unless isn't used with triple buffering, but GTA4 does by default.
But yeah, 15fps sounds low even for an old x1900. A friend of mine runs and x1950 along with an e6400@2.8GHz and found the game unplayable, but he was stll usually getting notably better framerates than that until he got into CPU heavy action.